| NPI | 1932652567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDRA F MICKELSON Manager Of Revenue Cycle Management 309-285-7752 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: IL 211000147) |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2024-09-24 |