| NPI | 1154306397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK LEE MCPHERSON President 309-833-1733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 042-004052) |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2020-08-22 |