| NPI | 1306199492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN MILLER Provider 312-720-8589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine | |
| 208VP0000X Pain Medicine, Pain Medicine | |
| Enumeration Date | 2012-10-26 |
| Last Update Date | 2022-05-26 |