| NPI | 1659503217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN M MILLER Nurse Practitioner 618-558-3955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209001766) |
| Enumeration Date | 2009-08-17 |
| Last Update Date | 2009-11-30 |