| NPI | 1235667593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE MEUNIER Chief Compliance Officer 217-784-2286 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 0000836) |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2022-07-21 |