| NPI | 1225102627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA L WELTER Director Hmo Administration 815-490-6752 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2020-08-22 |