NPI | 1932440625 |
---|---|
Doing Business As | SMH-PERU/ADULT MEDICINE CLINIC |
Doing Business As | IVCH MEDICAL GROUP / ADULT MEDICINE CLINIC |
Entity Type | Organization |
Authorized Contact | DORI BONNELL Director Of Physician Practices 815-780-3838 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
Enumeration Date | 2013-03-06 |
Last Update Date | 2021-01-28 |