| NPI | 1891812327 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR THOMAS NEEDHAM Director 708-481-9570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: IL A10420001A) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-08-22 |