| NPI | 1902134281 |
|---|---|
| Other Name | SA FREEPORT CLINIC |
| Entity Type | Organization |
| Authorized Contact | DON DANIELS VP 815-966-2084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| 207RP1001X Internal Medicine, Pulmonary Disease | |
| Enumeration Date | 2009-11-25 |
| Last Update Date | 2018-07-12 |