| NPI | 1750633293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE ANN HOLYCROSS Physician Assistant 217-597-9393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036112288) |
| Enumeration Date | 2012-10-08 |
| Last Update Date | 2012-11-09 |