| NPI | 1417680810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANUARY LEWIS TUCKER Billing Director/Cred Rep 630-300-3770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2022-07-05 |
| Last Update Date | 2023-06-07 |