| NPI | 1093835886 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRK MOBERG Senior Vice President 217-337-4105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207V00000X Obstetrics & Gynecology | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-08-22 |