| NPI | 1255594545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK G GANNON Medical Director 815-754-4882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1800X Clinic/Center, Corporate Health (Licence: IL 036-077643) |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2008-07-07 |