| NPI | 1568414134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FLORENCE L SPYROW Legal Counsel 309-779-2219 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 208000000X Pediatrics | |
| 208100000X Physical Medicine & Rehabilitation | |
| 208D00000X General Practice | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 364S00000X Clinical Nurse Specialist | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2008-04-14 |