| NPI | 1114126000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN THOMAS Office Manager 815-356-0475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036084823) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2011-10-18 |