| NPI | 1356845846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD FOELLNER Owner 217-800-2192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: IL 036.047282) |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2018-03-20 |