| 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 |