| NPI | 1902811714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN OLENEK Executive Director 815-740-8982 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2022-07-21 |