| NPI | 1225589740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE ADKINS Owner/Provider 618-937-0890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209002622) |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2016-10-19 |