NPI | 1518387109 |
---|---|
Entity Type | Organization |
Authorized Contact | JUSTIN R AHLMAN Owner 309-264-6124 |
Organization Subpart ? | No |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: IL 036113723) |
Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036113723) |
Enumeration Date | 2014-04-22 |
Last Update Date | 2014-04-22 |