| NPI | 1609336627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLENA GORDON Owner/ Physician 847-375-9711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2019-12-18 |