| NPI | 1851582928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN MIESNER Owner/Physician 815-434-4900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036091488) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IL 036091488) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2007-10-02 |