NPI | 1013335421 |
---|---|
Entity Type | Organization |
Authorized Contact | BRIAN J RUSSELL President 630-530-0506 |
Organization Subpart ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038006311) |
Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: IL 038006311) |
111NX0800X Chiropractor, Orthopedic (Licence: IL 038006311) | |
Enumeration Date | 2014-04-02 |
Last Update Date | 2014-04-02 |