| NPI | 1962599332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALPH DE JESUS President 847-998-1414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2020-08-22 |