| NPI | 1962417485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES BERTRAM WILLIAMS Owner/President 309-680-8666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2015-01-30 |