| NPI | 1760457204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM SCHULTZ Director 217-862-0500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IL 7002306) |
| Enumeration Date | 2006-02-20 |
| Last Update Date | 2010-01-11 |