| NPI | 1528725900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ANDREW FASICK Manager 847-345-3375 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation |
| Enumeration Date | 2021-11-20 |
| Last Update Date | 2021-11-20 |