| NPI | 1790730919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY NEWMAN Comptroller 815-227-9900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 363LW0102X Nurse Practitioner, Women's Health | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2020-08-22 |