| NPI | 1710095385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE M KANELLAKES Dr 815-744-2300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: IL 042003350) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2007-09-04 |