| NPI | 1720010168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB MUTHOLAM President/Administrator 708-489-6777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: IL 060-007270) |
| Additional Taxonomies | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: IL 060-007270) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2020-08-22 |