| NPI | 1396860433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY E DELL Office Manager 217-443-0146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 207Q00000x) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2020-08-22 |