| NPI | 1871201319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIGENA ZAIMI Manager 224-329-5602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| 261QP2000X Clinic/Center, Physical Therapy | |
| Enumeration Date | 2022-11-14 |
| Last Update Date | 2022-11-14 |