| NPI | 1467661215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY GEORGE GIBBONS President 847-697-2211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038-005809) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038-005860) |
| 208100000X Physical Medicine & Rehabilitation (Licence: IL 036-062567) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2007-11-26 |