| NPI | 1689946725 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY JAMES HARTLETT Pres. 815-344-1192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 111N00000X Chiropractor |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2012-02-06 |
| Last Update Date | 2012-02-06 |