NPI | 1538404827 |
---|---|
Entity Type | Organization |
Authorized Contact | RANAE D BERGMAN Office Manager 815-399-2190 |
Organization Subpart ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: IL 036110588) |
Enumeration Date | 2012-11-28 |
Last Update Date | 2013-09-06 |