| NPI | 1437476702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD KIM Executive Director 773-816-0141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: IL 036.056212) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038008098) |
| 111N00000X Chiropractor (Licence: IL 038011280) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: IL 336.057488) | |
| 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine (Licence: IL 036.056212) | |
| Enumeration Date | 2010-04-27 |
| Last Update Date | 2010-04-27 |