| NPI | 1649583600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE SUZANNE TEEL President 618-439-7171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: IL 038009609) |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2010-07-20 |