| NPI | 1487758801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY BRADFORD President 618-899-1001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 0004705) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 0004705) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: IL 0004705) | |
| 207RI0011X Internal Medicine Interventional Cardiology (Licence: IL 0004705) | |
| 2085R0001X Radiology Radiation Oncology (Licence: IL 0004705) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: IL 0004705) | |
| 227800000X Respiratory Therapist, Certified (Licence: IL 0004705) | |
| 227900000X Respiratory Therapist, Registered (Licence: IL 0004705) | |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2023-11-27 |