| NPI | 1225054331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINA G FOSTER Office Manager 815-561-9200 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2007-10-26 |