NPI | 1457603557 |
---|---|
Entity Type | Organization |
Authorized Contact | CAROL ANNE KOTZAN President 815-455-7200 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036076689) |
Enumeration Date | 2012-10-12 |
Last Update Date | 2013-03-25 |