| NPI | 1801291042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH SEVERSON Billing Department 847-742-5070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038011885) |
| Enumeration Date | 2014-10-30 |
| Last Update Date | 2022-11-02 |