# NGX ILLINOIS SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194438515
- **Authorized official:** ERIC SPEER (CHIEF FINANCIAL & HUMAN RESOURCES)
- **Authorized official phone:** (720) 339-0188

## Contact information

- **Practice address:** 456 NELSON RD, NEW LENOX, IL 60451-2946
- **Practice address phone:** (815) 527-6411
- **Practice address fax:** (815) 527-6411
- **Mailing address:** 456 NELSON RD, NEW LENOX, IL 60451-2946
- **Mailing address phone:** (815) 527-6411
- **Mailing address fax:** (815) 527-6411

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/30/2022
- **Last updated:** 12/30/2022