| NPI | 1023431426 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SITIHIAMPHONE PHETCHAMPHONE Doctor 630-495-1855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038009954) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: IL 198000604) |
| Enumeration Date | 2014-01-22 |
| Last Update Date | 2014-11-06 |