Itasca Health & Chiropractic Ltd. | |
1131 N Prospect Ave, Itasca, IL 60143-1442 | |
(630) 250-9200 | |
Not Available |
Full Name | Itasca Health & Chiropractic Ltd. |
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Type | Facility |
Speciality | Chiropractor |
Location | 1131 N Prospect Ave, Itasca, Illinois |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1518010545 | NPI | - | NPPES |
02227528 | Other | IL | BLUE CROSS BLUE SHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 038-008856 (Illinois) | Primary |
Provider Name | Joel L Hanson |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1790106383 PECOS PAC ID: 5991933814 Enrollment ID: I20140122000575 |
Mailing Address | Practice Location Address |
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Itasca Health & Chiropractic Ltd. 1131 N Prospect Ave, Itasca, IL 60143-1442 Ph: (630) 250-9200 | Itasca Health & Chiropractic Ltd. 1131 N Prospect Ave, Itasca, IL 60143-1442 Ph: (630) 250-9200 |
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