| NPI | 1851407373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA BOCKOVER Clinical Director 815-802-3170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IL 7003049) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2020-08-22 |