| NPI | 1700905205 |
|---|---|
| Doing Business As | CENTEGRA PHYSICIAN CARE, LLC |
| Entity Type | Organization |
| Authorized Contact | DAVID TOMLINSON CIO & CFO 815-788-5831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism | |
| 207RR0500X Internal Medicine, Rheumatology | |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| 363L00000X Nurse Practitioner | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2014-03-21 |