NPI | 1376894501 |
---|---|
Entity Type | Organization |
Authorized Contact | MARCEE A BRUMMEL Executive Director 630-499-2404 |
Organization Subpart ? | No |
Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine |
Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine |
207RS0010X Internal Medicine, Sports Medicine | |
2083S0010X Preventive Medicine, Sports Medicine | |
Enumeration Date | 2012-09-27 |
Last Update Date | 2018-02-21 |