NPI | 1508113580 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL L BROWN President 217-443-5201 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: IL 7002363) |
Enumeration Date | 2012-08-09 |
Last Update Date | 2012-08-09 |