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225 E Deerpath, #132, Lake Forest, IL 60045-1952 | |
(224) 544-5777 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Chiropractor - Nutrition |
Location | 225 E Deerpath, Lake Forest, Illinois |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1174896484 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111NN1001X | Chiropractor - Nutrition | 038008858 (Illinois) | Primary |
Mailing Address | Practice Location Address |
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225 E Deerpath, #132, Lake Forest, IL 60045-1952 Ph: (224) 544-5777 | 225 E Deerpath, #132, Lake Forest, IL 60045-1952 Ph: (224) 544-5777 |
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