| NPI | 1538369574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM ZAWACKI Office Manager 815-363-8866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: IL 0) |
| Additional Taxonomies | 174400000X Specialist (Licence: IL 036097592) |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2022-07-21 |