| NPI | 1255956751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL LE Physical Therapist 847-917-1476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2020-10-07 |