| NPI | 1033163829 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH PROVATEARE Director Support Services 309-779-2022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101Y00000X Counselor |
| 103T00000X Psychologist | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 363L00000X Nurse Practitioner | |
| 273R00000X Psychiatric Unit | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2017-04-11 |