| NPI | 1972572964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARSHALL F BRUSTEIN President, Board Of Directors 217-872-8204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IL 7002819) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2020-08-22 |