| NPI | 1487612024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL GERDES Officer Part Owner 309-762-1952 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IL 042006772) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2020-08-22 |