| |
755 Ela Rd Ste B, Lake Zurich, IL 60047-2412 | |
(847) 550-6500 | |
(847) 550-6595 |
Full Name | |
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Type | Facility |
Speciality | Chiropractor |
Location | 755 Ela Rd Ste B, Lake Zurich, Illinois |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1740511252 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | (* (Not Available)) | Primary |
Provider Name | Pranav P Vyas |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1447282678 PECOS PAC ID: 1759561475 Enrollment ID: I20110211000464 |
Mailing Address | Practice Location Address |
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755 Ela Rd Ste B, Lake Zurich, IL 60047-2412 Ph: (847) 550-6500 | 755 Ela Rd Ste B, Lake Zurich, IL 60047-2412 Ph: (847) 550-6500 |
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