| NPI | 1730138322 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA LEA LILJA President/Owner 815-623-1476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070005636) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2017-02-14 |