| NPI | 1568407146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT A. HALVORSON President 618-288-0030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036062276) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2020-08-22 |