| NPI | 1780017426 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAY YAZEJI Physician 309-696-5420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: IL 036116849) |
| Enumeration Date | 2013-08-16 |
| Last Update Date | 2013-11-11 |