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1801 Woodfield Dr Ste 106 Savoy IL 61874-9505 | |
| (217) 819-0043 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 1801 Woodfield Dr Ste 106, Savoy, Illinois |
| Authorized Official Name and Position | Jessica Wiley (OWNER) |
| Authorized Official Contact | 2178190043 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1801 Woodfield Dr Ste 106 Savoy IL 61874-9505 Ph: (217) 819-0043 | 1801 Woodfield Dr Ste 106 Savoy IL 61874-9505 Ph: (217) 819-0043 |
| NPI Number | 1093407173 |
|---|---|
| Provider Enumeration Date | 05/25/2023 |
| Last Update Date | 08/02/2023 |
| Certification Date | 08/02/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093407173 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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