| NPI | 1073807319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON KOTAS CFO 224-413-3927 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: IL 056.007545) |
| Enumeration Date | 2011-06-03 |
| Last Update Date | 2024-02-09 |