# ILLINOIS VALLEY PRIMARY CARE, LTD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851582928
- **Authorized official:** DAWN MIESNER D.O. (OWNER/PHYSICIAN)
- **Authorized official phone:** (815) 434-4900

## Contact information

- **Practice address:** 1209 STARFIRE DR, \#4, OTTAWA, IL 61350-1614
- **Practice address phone:** (815) 434-4900
- **Practice address fax:** (815) 434-2765
- **Mailing address:** 1209 STARFIRE DR, \#4, OTTAWA, IL 61350-1614
- **Mailing address phone:** (815) 434-4900
- **Mailing address fax:** (815) 434-2765

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | IL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | IL | — |

## Other

- **Enumeration date:** 08/05/2007
- **Last updated:** 10/02/2007