| NPI | 1376596718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUANA GRANADOS Credentialing Manager 630-575-1980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2020-06-29 |