| Organization Name: | OPTIMUM SPORTS AND SPINAL REHABILITATION, LTD. |
| NPI Number: | 1568641330 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARC SING (CLINIC DIRECTOR) |
| Mailing Address: | 101 Schelter Rd Suite B 101 Lincolnshire |
| State: | IL US |
| Postal Code: | 600693644 |
| Phone Number: | 8478211300 |
| Fax Number: | 8478211331 |
| NPI Enumeration Date: | 10/30/2007 |
| NPI Last Update Date: | 09/13/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 042.618640 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |