| NPI | 1932922200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY M SPOONER VP Of Revenue Cycle 630-978-2532 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2024-11-05 |
| Last Update Date | 2024-11-05 |