| NPI | 1962450734 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLEN B SMITH Chiref Operations Officer 309-662-5506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease |
| 207RI0011X Internal Medicine Interventional Cardiology | |
| 207UN0901X Nuclear Medicine Nuclear Cardiology | |
| 2085R0204X Radiology Vascular & Interventional Radiology | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2012-04-24 |