| NPI | 1780934166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH J ECKBURG President 815-751-6316 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2019-10-31 |