| NPI | 1912227620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES R WELFORD President 815-398-9386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-057923) |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2010-06-03 |