| NPI | 1801277884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMI S GOSSETT Owner 217-351-8040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: IL 038003750) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2015-06-15 |