| NPI | 1851303580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HONEID M. BAXAMUSA Owner 815-455-1550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IL 036-045522) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2020-08-22 |