| NPI | 1942088406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HARSH CHAWLA Physician 217-519-9654 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2023-09-18 |
| Last Update Date | 2023-09-18 |