| NPI | 1558473645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN T HALL President/Owner 618-244-7788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: IL 36060706) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |