| NPI | 1356956973 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA KANDIS GUTIERREZ Owner/Nurse Practitioner 815-685-4665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2020-09-10 |
| Last Update Date | 2024-04-09 |