Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
May 23, 2008
License(s)
070006928 (IL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | PO BOX 2103 | Naperville, IL 60567-2103 | 630-428-5850 |
| LOCATION | 1599 N FARNSWORTH AVE | Aurora, IL 60505-1530 | 428-585-5901 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.