| NPI | 1851323257 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEOFFREY TRYON VP Delegated Official 815-300-7112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-091635) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207T00000X Neurological Surgery | |
| 208600000X Surgery | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2021-11-05 |