Organization
WAUKEGAN MEDICAL & REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IVAN BRACIC D.C. (PRESIDENT/OWNER)
(847) 625-0202
Entity
Organization
Contact information
Practice address
1720 GRAND AVE, WAUKEGAN, IL 60085-3502
(847) 625-0202
(847) 625-0101
Mailing address
1720 GRAND AVE., WAUKEKGAN, IL 60085
(847) 625-0202
(847) 625-0101
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160004131
IL
Other
Enumeration date
12/13/2013
Last updated
12/13/2013
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