| NPI | 1366745739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNNETTE MCROY Billing Coordinator 773-767-3822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: IL 036112063) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038010670) |
| 111N00000X Chiropractor (Licence: IL 038008711) | |
| 174400000X Specialist (Licence: IL 036122087) | |
| 174400000X Specialist (Licence: IL 038011741) | |
| 174400000X Specialist (Licence: IL 070014443) | |
| 174400000X Specialist (Licence: IL 036084127) | |
| Enumeration Date | 2010-12-07 |
| Last Update Date | 2010-12-07 |