| 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 |