Organization
NEUROMONITORING SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PANNA U GOSWAMI MD (PHYSICIAN OWNER)
(309) 846-4716
Entity
Organization
Contact information
Practice address
1604 VISA DR STE 1, NORMAL, IL 61761-2195
(309) 454-1100
Mailing address
1604 VISA DR STE 1, NORMAL, IL 61761-2195
(309) 454-1100
(309) 218-1415
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036-061013
IL
Other
Enumeration date
03/08/2007
Last updated
08/30/2023
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