NPI | 1861569170 |
---|---|
Entity Type | Organization |
Authorized Contact | GREGORY TODD TRAPP President 815-935-1100 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036095931) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036095931) |
Enumeration Date | 2006-11-29 |
Last Update Date | 2008-08-06 |