NPI | 1588248249 |
---|---|
Entity Type | Organization |
Authorized Contact | PATRICK CAPLIS CEO 309-886-9172 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
Additional Taxonomies | 207R00000X Internal Medicine |
261QR0200X Clinic/Center, Radiology | |
207Q00000X Family Medicine | |
291U00000X Clinical Medical Laboratory | |
261QP2000X Clinic/Center, Physical Therapy | |
174400000X Specialist | |
332B00000X Durable Medical Equipment & Medical Supplies | |
261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
Enumeration Date | 2021-05-10 |
Last Update Date | 2025-10-02 |