| NPI | 1699894287 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN R WASEM Corporation President 217-428-2322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL CHIROPRACTOR) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2020-08-22 |