NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
1598752628 | CARROLL | KORI | L |   | 611 W PARK ST | URBANA | IL | 618012529 |
1801907431 | LI | PAUL | K |   | 611 W PARK ST | URBANA | IL | 618012529 |
1659757847 | LIEB | JENNIFER |   |   | 611 W. PARK ST. | URBANA | IL | 618012500 |
1710148739 | STAMS | VICTOR | EARL |   | 611 W PARK ST | URBANA | IL | 618012529 |