| NPI | 1760621833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARODE PUNDALEEKA President 815-725-1355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: IL 036052030) |
| Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: IL 036052030) |
| 2085R0001X Radiology, Radiation Oncology (Licence: IL 036052030) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036052030) | |
| Enumeration Date | 2009-02-13 |
| Last Update Date | 2009-02-13 |