| |
987 Oak Knoll Dr., Lake Forest, IL 60045-2635 | |
(847) 735-9609 | |
(847) 235-2439 |
Full Name | |
---|---|
Type | Facility |
Speciality | Clinic/center |
Location | 987 Oak Knoll Dr., Lake Forest, Illinois |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1306073747 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 03801172 (Illinois) | Secondary |
261Q00000X | Clinic/center | 198000814 (Illinois) | Secondary |
261Q00000X | Clinic/center | 198.000814 (Illinois) | Primary |
Mailing Address | Practice Location Address |
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987 Oak Knoll Dr, Lake Forest, IL 60045-2635 Ph: (847) 735-9609 | 987 Oak Knoll Dr., Lake Forest, IL 60045-2635 Ph: (847) 735-9609 |