| NPI | 1578304044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE DAWN CRAWFORD Owner 815-262-6518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 251J00000X Nursing Care |
| 363LA2200X Nurse Practitioner, Adult Health | |
| Enumeration Date | 2024-06-06 |
| Last Update Date | 2024-06-11 |