| NPI | 1770854416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE DANIEL MINGEA Director 815-363-9500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM CNP01327) |
| Enumeration Date | 2012-01-25 |
| Last Update Date | 2012-01-25 |