| NPI | 1790128817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALEB SUTTON Business Operations Manager 618-833-1691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036091188) |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2018-01-04 |