| NPI | 1699508291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE PHILLIPS Billing/Collections Specialist 309-342-4242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center Community Health |
| Enumeration Date | 2024-08-21 |
| Last Update Date | 2024-08-21 |