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12770 S Harlem Ave, Palos Heights, IL 60463-2145 | |
(708) 671-1400 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Chiropractor |
Location | 12770 S Harlem Ave, Palos Heights, Illinois |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1386643799 | NPI | - | NPPES |
01608565 | Other | IL | BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 038-005911 (Illinois) | Primary |
111N00000X | Chiropractor | 038-008937 (Illinois) | Secondary |
Provider Name | Robert T Wright |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1245239474 PECOS PAC ID: 1153226394 Enrollment ID: I20031202000149 |
Mailing Address | Practice Location Address |
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12770 S Harlem Ave, Palos Heights, IL 60463-2145 Ph: (708) 671-1400 | 12770 S Harlem Ave, Palos Heights, IL 60463-2145 Ph: (708) 671-1400 |
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