| NPI | 1003066010 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | LYNNETTE R MCROY Billing Coordinator 773-767-3822  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038008360)  | 
| Enumeration Date | 2008-09-26 | 
| Last Update Date | 2023-01-18 |