| NPI | 1356677462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANA MARLENE SUSIE Physical Therapist 773-733-1695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: IL 070.013558) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: IL 070.013558) |
| Enumeration Date | 2009-10-23 |
| Last Update Date | 2009-10-23 |