| NPI | 1902107733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA CLARK Administrator 309-687-4242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: IL 036084069) |
| Enumeration Date | 2010-11-10 |
| Last Update Date | 2010-11-10 |