| NPI | 1457629842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGARET A. ALLEN Office Manager 309-827-3881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: IL 036064804) |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2011-12-13 |