Illinois Valley Primary Care, Ltd

NPI #1851582928 in Ottawa, Illinois

Provider Information

NPI Number: 1851582928
Entity Type: Organization
Organization Name: Illinois Valley Primary Care, Ltd
Primary Specialty: Internal Medicine
Enumeration Date: Aug 5, 2007
Last Updated: Oct 2, 2007

Practice Location

Address: 1209 STARFIRE DR
Address 2: #4
City: Ottawa
State: Illinois
ZIP Code: 61350-1614
Phone: (815) 434-4900

Authorized Official

Name: DAWN MIESNER, D.O.
Title: OWNER/PHYSICIAN
Phone: (815) 434-4900

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Obstetrics & Gynecology	207V00000X
Internal Medicine	207R00000X	Primary

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