| NPI | 1558467936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLA SUE CHRISTENSEN Billing/Collections Manager 217-424-1021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center Urgent Care |
| Additional Taxonomies | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: IL 7002363) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2008-10-14 |