| NPI | 1881919827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAM GAINES Physician 217-793-5266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| Enumeration Date | 2010-04-01 |
| Last Update Date | 2010-07-15 |