Registry details
Type
Individual
Primary specialty
Internal Medicine, Cardiovascular Disease
Enumerated
May 10, 2006
License(s)
036106477 (IL), 036106477 (IL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 611 W PARK ST | Urbana, IL 61801-2500 | 217-904-7000 |
| MAILING | 611 W PARK ST FAPC | Urbana, IL 61801 | 217-902-5291 |
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