| NPI | 1669840575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANELL M PETTRY Office Manager 309-621-4604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367A00000X Advanced Practice Midwife (Licence: IL 209013293) |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2015-09-09 |