| NPI | 1285061101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY P ORTIZ Owner 815-942-0003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0700X Clinic/Center, Hearing and Speech (Licence: IL 2387) |
| Enumeration Date | 2013-10-09 |
| Last Update Date | 2013-10-09 |