| NPI | 1023235348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN W ANDERSON President 618-244-7788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036035666) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2020-08-22 |