| NPI | 1699951293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN B. ROTH President 815-942-0683 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: IL 036044899) |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2008-01-14 |