| NPI | 1770656647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVETTE SOUHLAS Staff Physical Therapist 773-327-2880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070.012817) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2020-08-22 |