| NPI | 1699879718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY R CANHAM President 217-877-8925 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: IL 036060206) |
| Additional Taxonomies | 208800000X Urology |
| 208800000X Urology (Licence: IL 036056608) | |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2020-08-22 |