| NPI | 1881434868 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAMIDELE EKUNSANMI CEO 217-356-3400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2024-05-28 |
| Last Update Date | 2024-11-26 |