| NPI | 1700010915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA R. ERNAT President 815-223-8265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: IL 041-155635) |
| Enumeration Date | 2009-05-04 |
| Last Update Date | 2009-05-04 |