| NPI | 1538498209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD D. CORLEY Direct Owner 309-674-2822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: IL 036-037-295) |
| Enumeration Date | 2009-12-09 |
| Last Update Date | 2009-12-09 |