| NPI | 1528233111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA SUE BRADY Practice Manager 309-662-0088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IL 36-098820) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2022-10-03 |