| NPI | 1780863910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANILO GUNGON CAPATI President 309-685-1038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: IL 036060832) |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2008-02-05 |