| NPI | 1083655336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUBHADRA S VUNDAVILLI Physical Therapist 312-569-6397 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: IL 070-014450) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2020-08-22 |