| NPI | 1619922515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID A BLACK Owner/Executive Officer 815-227-1700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 060-008176) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2013-01-08 |