| NPI | 1972802007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WASEEM AHMAD Owner 309-236-3174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036116005) |
| Enumeration Date | 2011-03-15 |
| Last Update Date | 2011-03-15 |