| NPI | 1003034315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE VANFOSSEN VP 847-439-2954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038009222) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038009225) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-08-22 |