NPI | 1982721353 |
---|---|
Entity Type | Organization |
Authorized Contact | ROBERT LEE MULL Director Of Patient Accounts 815-300-7139 |
Organization Subpart ? | No |
Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment (Licence: IL 1706432) |
Enumeration Date | 2007-03-23 |
Last Update Date | 2012-04-11 |