| NPI | 1114106978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SETH K OSAFO President 309-690-3369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036099549) |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2007-10-29 |