| NPI | 1023855475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER WHALEN Director 217-737-3508 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2024-07-12 |
| Last Update Date | 2025-01-27 |