| NPI | 1477546935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARYN HALL Om 630-450-2088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 042617710) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 042617710) |
| 208100000X Physical Medicine & Rehabilitation (Licence: IL 042617710) | |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2022-05-19 |