| NPI | 1669520177 |
|---|---|
| Doing Business As | CAPITOL COMMUNITY HEALTH CENTER - ST JOHN'S BREADLINE |
| Entity Type | Organization |
| Authorized Contact | CINDY KAVANAGH Accountant 217-788-2300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208000000X Pediatrics | |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2010-09-21 |