| NPI | 1962583260 |
|---|---|
| Other Name | LICENSED ILLINOIS CORPORATION |
| Entity Type | Organization |
| Authorized Contact | ERNST VON HOCH President Director 630-420-1148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038003958) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2020-08-22 |