| NPI | 1063871390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL ELIZABETH HOWE Owner 815-477-8844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: IL 085.004468) |
| Additional Taxonomies | 111NR0400X Chiropractor Rehabilitation (Licence: IL 038.008097) |
| 111NR0400X Chiropractor Rehabilitation (Licence: IL 038.006954) | |
| 111NR0400X Chiropractor Rehabilitation (Licence: IL 038.009872) | |
| Enumeration Date | 2016-02-15 |
| Last Update Date | 2016-02-15 |