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Organization
SOUTHWEST SPORTS & SPINAL REHAB INC
Active
Organization
SOUTHWEST SPORTS & SPINAL REHAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YELENA Y POTEKHINA (PRESIDENT)
(708) 532-0000
Entity
Organization
Contact information
Practice address
16532 OAK PARK AVE STE 100, TINLEY PARK, IL 60477-2268
(708) 532-0000
Mailing address
16532 OAK PARK AVE STE 100, TINLEY PARK, IL 60477-2268
(708) 532-0000
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038-008962
IL
Other
Enumeration date
10/01/2012
Last updated
10/01/2012
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