| NPI | 1619039724 |
|---|---|
| Other Name | SAMG BROOKSIDE |
| Entity Type | Organization |
| Authorized Contact | DON DANIELS VP 815-966-2084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2013-07-30 |