| NPI | 1457662116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY T. SYLORA Owner 815-469-9392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 36-046363) |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2010-06-28 |