NPI | 1043323793 |
---|---|
Entity Type | Organization |
Authorized Contact | GERALDINE THORNHILL WIRTH Nurse Practitioner 217-875-2670 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: IL 041-212936) |
Enumeration Date | 2006-08-16 |
Last Update Date | 2020-08-22 |