| NPI | 1851926869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY OWENS Director Of Finance 815-300-7106 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2020-03-10 |
| Last Update Date | 2021-11-05 |