| NPI | 1982902342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID B. YABLONSKY Owner / Physician 618-628-8211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036115282) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036115282) |
| Enumeration Date | 2011-03-09 |
| Last Update Date | 2015-12-08 |