Organization
ILLINOIS VALLEY PRIMARY CARE, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN MIESNER D.O. (OWNER/PHYSICIAN)
(815) 434-4900
Entity
Organization
Contact information
Practice address
1209 STARFIRE DR, #4, OTTAWA, IL 61350-1614
(815) 434-4900
(815) 434-2765
Mailing address
1209 STARFIRE DR, #4, OTTAWA, IL 61350-1614
(815) 434-4900
(815) 434-2765
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
IL
207V00000X
Obstetrics & Gynecology Physician
—
IL
Other
Enumeration date
08/05/2007
Last updated
10/02/2007
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