Organization
ILLINOIS ASSOCIATION OF MICROBOARDS AND COOPERATIVES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VICKI J NISWANDER (EXECUTIVE DIRECTOR)
(217) 778-5388
Entity
Organization
Contact information
Practice address
104 WOODCREEK CT, MAHOMET, IL 61853-9185
(217) 778-5388
(217) 586-4552
Mailing address
104 WOODCREEK CT, MAHOMET, IL 61853-9185
(217) 778-5388
(217) 586-4552
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
11/10/2010
Last updated
11/10/2010
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