| NPI | 1548281579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAO V MOVVA President 309-762-5560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: IL 1685087) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2022-07-21 |