| NPI | 1700018538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN E PODZAMSKY President 309-432-2441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IL 036055223) |
| Enumeration Date | 2009-08-12 |
| Last Update Date | 2012-12-19 |