| NPI | 1598951063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLE BARNETT Practice Manager 309-664-1007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: IL 036110975) |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2013-07-16 |