| NPI | 1750866588 |
|---|---|
| Doing Business As | ILLINOIS |
| Entity Type | Organization |
| Authorized Contact | KELLY JACK Ar Technical Manager 856-782-2212 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2018-09-27 |