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 |