| NPI | 1952310179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KISHOR G AJMERE Physician 815-744-6023 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-052843) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2020-08-22 |