| NPI | 1861688699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECKY ROSS Owner 815-514-8513 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: IL 038.010966) |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2010-12-23 |