| NPI | 1093085060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE MYJAK President 815-245-3845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: IL 070.007032) |
| Enumeration Date | 2012-01-09 |
| Last Update Date | 2012-01-09 |