| NPI | 1508179722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA K. MCDONALD Credentialing Coordinator 618-257-4644 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: IL 036115955) |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2013-02-19 |