| NPI | 1932380078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VORAPHOT SATHISSARAT Head Of Corporation 815-741-1212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: IL 036046328) |
| Enumeration Date | 2007-11-16 |
| Last Update Date | 2010-11-02 |