| NPI | 1427003318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID A. BLACK Owner/Executive Officer 815-227-1700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 060-007530) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2014-01-28 |