| NPI | 1326404682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA NORTHWAY Practice Manager 815-893-8480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: IL 070016104) |
| Enumeration Date | 2016-01-01 |
| Last Update Date | 2020-07-07 |