| NPI | 1861668956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE MILLER Physical Therapist 815-405-7990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: IL 070.010384) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2025-02-28 |