| NPI | 1184667438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRICIA OLAGUES Practice Manager 815-227-0055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2024-08-06 |