| NPI | 1639224827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET BOWER Director 815-928-9999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IL 7002702) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2020-08-22 |