| NPI | 1801051669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA K. GALE Owner 815-877-7237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: IL 038008655) |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2008-07-22 |