| NPI | 1871713552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID A JOHNSON Director 847-295-0920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy (Licence: IL 042007526) |
| Additional Taxonomies | 111NX0800X Chiropractor Orthopedic (Licence: IL 042007526) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2011-11-08 |