Provider Demographics
NPI:1326685306
Name:FUNCTIONAL MOVEMENT AND PERFORMANCE, LTD.
Entity Type:Organization
Organization Name:FUNCTIONAL MOVEMENT AND PERFORMANCE, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRADY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHUYLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:632-535-5505
Mailing Address - Street 1:7925 BROOKBANK RD
Mailing Address - Street 2:
Mailing Address - City:WILLOWBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527-2423
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7925 BROOKBANK RD
Practice Address - Street 2:
Practice Address - City:WILLOWBROOK
Practice Address - State:IL
Practice Address - Zip Code:60527-2423
Practice Address - Country:US
Practice Address - Phone:630-253-5505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-09
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty