| NPI | 1487634390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIVA K ELANGOVAN President, & Med Director 309-762-5560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 207RG0100X Internal Medicine, Gastroenterology | |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: IL 036105933) | |
| 208C00000X Colon & Rectal Surgery | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2021-11-12 |