NPI | 1316772882 |
---|---|
Entity Type | Organization |
Authorized Contact | BYRON WILLIAMS Owner 815-919-2362 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 106H00000X Marriage & Family Therapist |
2084P0800X Psychiatry & Neurology, Psychiatry | |
251S00000X Community/Behavioral Health | |
363L00000X Nurse Practitioner | |
Enumeration Date | 2024-09-04 |
Last Update Date | 2025-01-28 |