| NPI | 1629384607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOE DANT Vice President Business Development 815-756-1521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2010-08-27 |