| NPI | 1467860833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA YATES Director Of Business Services 815-999-3001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2014-07-29 |
| Last Update Date | 2014-07-29 |