| NPI | 1861548869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT FRICKE Provider 618-234-5237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036043822) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2020-08-22 |