| 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 |