| NPI | 1770720682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE SOUTHWORTH Owner 815-729-2999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QX0100X Clinic/Center, Occupational Medicine (Licence: IL 225XOOOOOX) |
| Enumeration Date | 2009-01-14 |
| Last Update Date | 2009-01-14 |