| NPI | 1962642140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK DUANE EVARD VP Of Revenue Cycle 217-492-9651 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0200X Clinic/Center, Radiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2009-02-27 |
| Last Update Date | 2024-10-31 |