NPI | 1508826983 |
---|---|
Entity Type | Organization |
Authorized Contact | TAMMY SPOONER VP Of Revenue Cycle 630-978-2532 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice |
Additional Taxonomies | 251E00000X Home Health (Licence: IL 1001650) |
251G00000X Hospice Care, Community Based (Licence: IL 2001196) | |
261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
Enumeration Date | 2006-03-28 |
Last Update Date | 2024-07-31 |