| NPI | 1124535240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDRIC WOLNER Member 708-938-3378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| 133V00000X Dietitian, Registered | |
| Enumeration Date | 2018-01-10 |
| Last Update Date | 2025-08-28 |