| NPI | 1104559814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HELEN ANNE KUEHLMAN Medical Director / Owner Of LLC 815-531-4028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2022-07-08 |
| Last Update Date | 2022-07-18 |