| NPI | 1578086500 |
|---|---|
| Doing Business As | GREGORY DELOST, MD |
| Entity Type | Organization |
| Authorized Contact | MATTHEW ERTEL Chief Financial Officer 217-784-2601 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 0000836) |
| Enumeration Date | 2017-07-21 |
| Last Update Date | 2020-03-17 |