| NPI | 1275835571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA FOSTER Credentialing Specialist 815-713-2600 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QU0200X Clinic/Center Urgent Care (Licence: LA DO0000012) |
| Enumeration Date | 2010-11-19 |
| Last Update Date | 2011-03-21 |