| NPI | 1902849227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL P JONES President 618-277-1130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IL 7001316) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2016-09-23 |