Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
School |
363LS0200X | 50 | Nurse Practitioner |
| NPI # | 1609685189 |
| LBN Legal business name | METHODIST MEDICAL CENTER OF ILLINOIS |
| Authorized official | KEITH KNEPP - (PRESIDENT) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 12/30/2024 |
| Last updated | 12/30/2024 - More than a year ago |
| Identifiers | n/a |
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