| NPI | 1629180666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NUSRAT ALI KHAN Co Owner 815-935-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |