| NPI | 1942722368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARACELI LEAR Office Manager 309-291-0479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0000X Family Medicine, Adolescent Medicine (Licence: IL 036078962) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: IL 036078962) |
| Enumeration Date | 2017-07-07 |
| Last Update Date | 2022-07-21 |