NPI | 1821288945 |
---|---|
Entity Type | Organization |
Authorized Contact | ANNETTE WELLS Office Administrator 815-937-2044 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036068108) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036068108) |
Enumeration Date | 2007-07-25 |
Last Update Date | 2009-12-23 |