| NPI | 1215578109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRIS WESLEY CEO 217-545-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-10-02 |
| Last Update Date | 2019-10-02 |