| NPI | 1639969405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMISHIA LITTLE Authorized Rep 773-960-1202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QI0500X Clinic/Center, Infusion Therapy |
| Additional Taxonomies | 207RS0010X Internal Medicine, Sports Medicine |
| 261Q00000X Clinic/Center | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| Enumeration Date | 2025-05-07 |
| Last Update Date | 2025-05-07 |