| NPI | 1801687066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA RENEE ANDRICKS CEO 217-877-6111 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2025-05-15 |
| Last Update Date | 2025-05-15 |