| NPI | 1952380628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER ROBERTSON Practice Administrator 309-589-8051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: IL 042000742) |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2023-12-04 |