| NPI | 1417647066 |
|---|---|
| Doing Business As | CLINIC OF BELVIDERE |
| Entity Type | Organization |
| Authorized Contact | JACLYN NEWHART Manager 708-653-3496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2023-05-08 |
| Last Update Date | 2023-09-29 |