| NPI | 1639354590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN K GREEN Owner 847-359-7600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 111NR0400X (Licence: IL 038004314) |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2016-04-26 |