NPI | 1851526933 |
---|---|
Entity Type | Organization |
Authorized Contact | DIANE L TIPPY Billing Administrator 815-729-7790 |
Organization Subpart ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036082815) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178005617) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036072698) | |
Enumeration Date | 2009-05-19 |
Last Update Date | 2009-05-19 |