| NPI | 1619029881 |
|---|---|
| Other Name | SA MIDTOWN CLINIC |
| Entity Type | Organization |
| Authorized Contact | DON DANIELS VP 815-966-2084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2018-07-12 |