Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1487670956 |
---|---|
Provider Name | Mr. Craig Donald Ing |
First Address | Addison, IL 60101-3709 |
Second Address | Elk Grove Village, IL 60007-3392 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2006 |
Last Update Date | 08/07/2007 |