| NPI | 1144008939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK CAPLIS CEO 309-886-9172 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 174400000X Specialist |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 261Q00000X Clinic/Center | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 291U00000X Clinical Medical Laboratory | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2023-09-21 |
| Last Update Date | 2024-07-25 |