| NPI | 1295104958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY SPOONER A VP Of Practice Management Systems 630-978-9754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2015-09-23 |