| NPI | 1952560013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE L FANCHER President 217-464-5839 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
| Enumeration Date | 2008-06-04 |
| Last Update Date | 2008-08-08 |