NPI | 1225279680 |
---|---|
Entity Type | Organization |
Authorized Contact | TRACEY DAWN KINIGAKIS Proprietor 815-618-8116 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036-095213) |
Enumeration Date | 2009-03-16 |
Last Update Date | 2009-03-16 |