| NPI | 1508826983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY SPOONER A VP Of Practice Management Systems 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 | 2016-11-18 |