NPI | 1578611000 |
---|---|
Entity Type | Organization |
Authorized Contact | CINDY KAVANAGH Accountant 217-788-2300 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 207Q00000X Family Medicine |
207R00000X Internal Medicine | |
208000000X Pediatrics | |
Enumeration Date | 2007-01-08 |
Last Update Date | 2015-10-07 |