| NPI | 1821116468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KWABENA A BOATENG Physician 815-553-0500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: IL 036084514) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2008-03-27 |