| NPI | 1003855933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKI ANN JENSEN President 815-730-1818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant |
| Additional Taxonomies | 225000000X Orthotic Fitter |
| 225100000X Physical Therapist | |
| 2251P0200X Physical Therapist Pediatrics | |
| 225200000X Physical Therapy Assistant | |
| 225X00000X Occupational Therapist | |
| 225XP0200X Occupational Therapist Pediatrics | |
| 235Z00000X Speech-Language Pathologist | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2020-08-22 |