| NPI | 1710020052 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENNETT P SCAGLIA Medical Director 309-888-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2020-08-22 |