NPI | 1356592828 |
---|---|
Entity Type | Organization |
Authorized Contact | TISA ANNE MORRIS-CHRISTIAN Owner 815-464-0081 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036101122) |
Enumeration Date | 2008-10-02 |
Last Update Date | 2021-02-10 |