| NPI | 1851731640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW VERNEY Program Director 217-545-0193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 284300000X Special Hospital (Licence: IL 125063931) |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2013-06-26 |