| NPI | 1235563073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IDRIS OMOSANYA Physical Therapist 708-268-0862 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070019896) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: IL 056005754) |
| Enumeration Date | 2013-08-28 |
| Last Update Date | 2019-02-26 |