NPI | 1134781974 |
---|---|
Entity Type | Organization |
Authorized Contact | ROBERT VAN HIGGINBOTTOM CEO 773-667-9053 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Additional Taxonomies | 111N00000X Chiropractor |
111NR0400X Chiropractor, Rehabilitation | |
261QH0100X Clinic/Center, Health Services | |
261QM2500X Clinic/Center, Medical Specialty | |
261QP2000X Clinic/Center, Physical Therapy | |
261QP2300X Clinic/Center, Primary Care | |
261QP3300X Clinic/Center, Pain | |
261QR0200X Clinic/Center, Radiology | |
261QR0400X Clinic/Center, Rehabilitation | |
261QR0800X Clinic/Center, Recovery Care | |
302R00000X Health Maintenance Organization | |
305R00000X Preferred Provider Organization | |
305S00000X Point of Service | |
332B00000X Durable Medical Equipment & Medical Supplies | |
Enumeration Date | 2019-07-02 |
Last Update Date | 2020-05-29 |