| NPI | 1730211475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN ANNE NABONG Business Manager 815-344-0734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: IL 036052875) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2011-03-03 |