| NPI | 1598125031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERYL L MILLER Practice Manager 217-330-9788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036092026) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036107742) |
| Enumeration Date | 2016-02-25 |
| Last Update Date | 2016-02-25 |