| NPI | 1184649410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL L LOWE Accounting Clerk 815-431-3265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: IL 042-000502) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2008-06-20 |