| NPI | 1912097858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY A. BAUMGARDNER Sole Proprietor 309-342-3565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: IL 036116282) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2020-08-22 |