| NPI | 1700510740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARRYD EDWARD MCGUIRE Nurse Practitioner 815-429-7739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-07-14 |
| Last Update Date | 2022-07-14 |