| NPI | 1154652402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD ANTHONY O'MALLEY President 815-293-3740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-008577) |
| Enumeration Date | 2010-01-27 |
| Last Update Date | 2012-02-20 |