| NPI | 1700925930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE J SCHAAFSMA Public Health Administrator 815-802-9393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2012-05-03 |