| NPI | 1366321515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EBONY WALKER Family Nurse Practitioner 217-918-5184 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2025-09-01 |
| Last Update Date | 2026-04-09 |