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 |