| |
400 N Wells St Ste 340, Chicago, IL 60654-2761 | |
(513) 965-1851 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Clinic/center |
Location | 400 N Wells St Ste 340, Chicago, Illinois |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1164939369 | NPI | - | NPPES |
1902903255 | Other | IL | NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | (* (Not Available)) | Secondary |
261Q00000X | Clinic/center | 038.003947 (Illinois) | Primary |
Mailing Address | Practice Location Address |
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400 N Wells St Ste 340, Chicago, IL 60654-2761 Ph: (513) 965-1851 | 400 N Wells St Ste 340, Chicago, IL 60654-2761 Ph: (513) 965-1851 |