| NPI | 1811172877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD J RICHARD Executive Director 309-779-7242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.004883) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-005341) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209003631) | |
| 1041C0700X Social Worker, Clinical (Licence: IA 05255) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IA 062587) | |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2010-12-21 |