| NPI | 1972763613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA WORKMAN Office Manager 815-932-3132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: IL 036-081606) |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2022-12-15 |