| NPI | 1912216284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRENE MARY BOSWELL Physician 815-332-1777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036091532) |
| Enumeration Date | 2010-10-04 |
| Last Update Date | 2010-10-04 |