| NPI | 1639790884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HABIBA SEIDU-FUSEINI Fnp C 309-264-2256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2023-05-12 |