| NPI | 1306040878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHOEBE PANOPIO Dr 309-452-0995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: IL 036094859) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2013-11-20 |