| NPI | 1871608711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE ELMER Manager, Credentialing And Risk Man 815-381-7431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IL 060-012290) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2024-04-19 |