| NPI | 1477276301 |
|---|---|
| Doing Business As | PROFESSIONAL FEES |
| Entity Type | Organization |
| Authorized Contact | JUDI L HARLAN Network Development And Partnership 217-588-2882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2022-09-26 |
| Last Update Date | 2022-09-27 |