| NPI | 1912397480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA REYNOLDS Authorized Official 773-484-4783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 273Y00000X Rehabilitation Unit |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2024-02-16 |