| NPI | 1174739122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRETCHEN L CROMER President 309-764-3912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: IL 036100762) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2020-08-22 |