| NPI | 1407039266 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN MARIE EARLEY Office Manager 309-757-9191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: IL 036082773) |
| Enumeration Date | 2007-12-14 |
| Last Update Date | 2008-11-05 |