| NPI | 1912146119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARIN ANNIKA BLUMOFE General Surgeon 815-227-2274 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036093795) |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2009-02-11 |