NPI | 1205223781 |
---|---|
Entity Type | Organization |
Authorized Contact | SCOTT STUCK Owner 815-230-9070 |
Organization Subpart ? | No |
Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: IL 227.015217) |
Enumeration Date | 2015-04-22 |
Last Update Date | 2015-04-22 |