| NPI | 1023716875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY PARK Owner 815-872-7447 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine |
| Additional Taxonomies | 207LH0002X Anesthesiology, Hospice and Palliative Medicine |
| 207PH0002X Emergency Medicine, Hospice and Palliative Medicine | |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine | |
| 207VH0002X Obstetrics & Gynecology, Hospice and Palliative Medicine | |
| 2080H0002X | |
| 2081H0002X Physical Medicine & Rehabilitation, Hospice and Palliative Medicine | |
| 2084H0002X Psychiatry & Neurology, Hospice and Palliative Medicine | |
| 2085H0002X Radiology, Hospice and Palliative Medicine | |
| 2086H0002X Surgery, Hospice and Palliative Medicine | |
| 2278P3800X Respiratory Therapist, Certified, Palliative/Hospice | |
| 251G00000X Hospice Care, Community Based | |
| Enumeration Date | 2023-02-21 |
| Last Update Date | 2025-01-31 |