| NPI | 1750532362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN ENGLAND Vice President, Business Developmen 217-788-3851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| 207R00000X Internal Medicine | |
| 208000000X Pediatrics | |
| 2083X0100X Preventive Medicine, Occupational Medicine | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2008-10-02 |