| NPI | 1952556136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE BRANDON Practice Manager 847-622-0506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070010906) |
| Enumeration Date | 2008-12-01 |
| Last Update Date | 2011-11-21 |