| NPI | 1003080870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA CHEATHAM President 815-806-1966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 03655042) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041135945) |
| 163W00000X Registered Nurse (Licence: IL 041259415) | |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2008-04-14 |