| NPI | 1649421512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LYNN MCCABE Pediatric Dietitian 217-280-0220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: IL JM99120799P) |
| Enumeration Date | 2008-10-09 |
| Last Update Date | 2008-10-09 |