| NPI | 1871093047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA O'CONNOR Administrator 815-602-8253 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Enumeration Date | 2018-02-14 |
| Last Update Date | 2018-02-14 |