| NPI | 1780885343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID MICHAEL BURT Owner 815-267-8825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IL 036-111005) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2009-07-08 |