| NPI | 1629213814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN C SNIDER Cnp 309-278-0566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209005824) |
| Enumeration Date | 2008-12-02 |
| Last Update Date | 2008-12-02 |