| NPI | 1922976133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELVERTA WILKINS Chief Executive Officer 217-520-7308 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QC1500X Clinic/Center Community Health |
| Enumeration Date | 2025-10-28 |
| Last Update Date | 2025-10-28 |