| NPI | 1568890325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JAMES SCHOTT Owner/Sole Practioner 309-517-6177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: IL 036095373) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036095373) |
| Enumeration Date | 2013-10-14 |
| Last Update Date | 2013-10-14 |