| NPI | 1992821110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA AREVALO Owner 708-602-1581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: IL 070012475) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-08-22 |