| NPI | 1881786622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA OLT President 309-692-2805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2020-08-22 |