| NPI | 1437462975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLENE K HENZE President 815-416-1331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: IL 036093007) |
| Enumeration Date | 2010-07-26 |
| Last Update Date | 2011-09-20 |