NPI | 1184927311 |
---|---|
Entity Type | Organization |
Authorized Contact | MARK CANTY Owner 309-258-7822 |
Organization Subpart ? | No |
Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: IL 036082935) |
Enumeration Date | 2010-12-09 |
Last Update Date | 2010-12-09 |