| NPI | 1487833992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN M EVERINGHAM Senior Assoicate 309-663-8388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: IL 060002911- 038007235) |
| Enumeration Date | 2007-10-31 |
| Last Update Date | 2007-10-31 |