NPI | 1073793345 |
---|---|
Entity Type | Organization |
Authorized Contact | SHAWN M BRETON President, CEO 847-368-1234 |
Organization Subpart ? | No |
Primary Taxonomy | 111NI0900X Chiropractor, Internist (Licence: IL 038008779) |
Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: IL 038.009584) |
Enumeration Date | 2007-11-05 |
Last Update Date | 2024-08-03 |