| NPI | 1033484704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALDO CARMEN RUFFOLO President And Sole Member 217-345-2100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 248000561) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 248000561) |
| Enumeration Date | 2012-03-14 |
| Last Update Date | 2012-03-14 |