| NPI | 1609675818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA BROTCKE Manager 815-986-0855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2025-03-10 |
| Last Update Date | 2025-10-28 |