NPI | 1942428644 |
---|---|
Entity Type | Organization |
Authorized Contact | VIRGILIO C CASTILLO President 773-878-2660 |
Organization Subpart ? | No |
Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: IL 038008973) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038-009043) |
Enumeration Date | 2007-04-20 |
Last Update Date | 2011-09-02 |