| NPI | 1790739894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH R THOMAE President 618-654-8100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IL 7002868) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2010-06-01 |