| NPI | 1629218466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAILEY BOYD Business Office Manager 217-693-5703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2009-03-05 |
| Last Update Date | 2025-05-01 |