| NPI | 1679961742 |
|---|---|
| Doing Business As | MIDWEST EXPRESS CLINIC |
| Entity Type | Organization |
| Authorized Contact | AMY VERTIN Owner 815-681-7733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209010489) |
| Enumeration Date | 2014-12-24 |
| Last Update Date | 2015-04-20 |