| Loop Spine & Sports Center, Ltd. | |
|
30 N Michigan Ave Ste 605, Chicago, IL 60602-3806 | |
| (312) 422-0042 | |
| Not Available |
| Full Name | Loop Spine & Sports Center, Ltd. |
|---|---|
| Type | Facility |
| Speciality | Chiropractor - Sports Physician |
| Location | 30 N Michigan Ave Ste 605, Chicago, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972975464 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111NS0005X | Chiropractor - Sports Physician | 038007857 (Illinois) | Primary |
| Provider Name | Renald A Trottier |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1992922934 PECOS PAC ID: 6901990209 Enrollment ID: I20070918000119 |
| Mailing Address | Practice Location Address |
|---|---|
| Loop Spine & Sports Center, Ltd. 6480 Cherokee Dr, Indian Head Park, IL 60525-4321 Ph: (312) 437-9355 | Loop Spine & Sports Center, Ltd. 30 N Michigan Ave Ste 605, Chicago, IL 60602-3806 Ph: (312) 422-0042 |
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