NPI | 1518993930 |
---|---|
Entity Type | Organization |
Authorized Contact | DOMINIC CHARLES IMBURGIA President 217-347-2900 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 207R00000X Internal Medicine |
Enumeration Date | 2006-06-25 |
Last Update Date | 2007-08-14 |