| NPI | 1932560414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHANIEL VIZCAYNO Owner 847-409-6643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-011571) |
| Enumeration Date | 2016-03-11 |
| Last Update Date | 2016-03-11 |