| NPI | 1861670101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW KONG Owner 815-397-8500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| 207L00000X Anesthesiology | |
| Enumeration Date | 2008-02-08 |
| Last Update Date | 2013-10-28 |