| NPI | 1780852244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL MILLER President & CEO 815-490-1737 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2008-02-18 |
| Last Update Date | 2022-08-24 |