| NPI | 1629275821 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SITSADAPHONE PENG PHETCHAMPHONE Owner 630-833-3799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2020-08-22 |