| NPI | 1700993896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANSAR H ANSARI President 217-285-4414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: IL 036048201) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IL 036048202) |
| 208600000X Surgery (Licence: IL 036048201) | |
| 208D00000X General Practice (Licence: IL 036048202) | |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2025-09-11 |