NPI | 1174877930 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMES T DOWELL Vice President, Mps 217-788-3342 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 101Y00000X Counselor |
1041C0700X Social Worker, Clinical | |
207R00000X Internal Medicine | |
208000000X Pediatrics | |
363A00000X Physician Assistant | |
363L00000X Nurse Practitioner | |
Enumeration Date | 2012-11-01 |
Last Update Date | 2020-06-11 |