| NPI | 1407948748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAKHRY WILSON AZER President 309-344-3400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251G0304X Physical Therapist Geriatrics |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2023-03-16 |