| NPI | 1568426260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN R AHLMAN CEO 309-692-9210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IL 7001449) |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2019-02-25 |