| NPI | 1447671516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI PATTERSON Billing Manager 815-463-0098 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036063687) |
| Enumeration Date | 2013-12-17 |
| Last Update Date | 2014-03-18 |