| NPI | 1114057312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH F. LAHUE Administrator 618-624-9384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: IL 070-009821) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038-010210) |
| 111N00000X Chiropractor (Licence: IL 038-007626) | |
| 111N00000X Chiropractor (Licence: IL 038-010516) | |
| 111N00000X Chiropractor (Licence: IL 038-005079) | |
| 111NN1001X Chiropractor, Nutrition (Licence: IL 038-010210) | |
| 111NN1001X Chiropractor, Nutrition (Licence: IL 038-007626) | |
| 111NN1001X Chiropractor, Nutrition (Licence: IL 038-010516) | |
| 111NN1001X Chiropractor, Nutrition (Licence: IL 038-005079) | |
| 111NR0400X Chiropractor, Rehabilitation (Licence: IL 038-010210) | |
| 111NR0400X Chiropractor, Rehabilitation (Licence: IL 038-007626) | |
| 111NR0400X Chiropractor, Rehabilitation (Licence: IL 038-010516) | |
| 111NR0400X Chiropractor, Rehabilitation (Licence: IL 038-005079) | |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2025-09-11 |