Davenport Chiropractic Wellness Center Pc | |
3350 W Salt Creek Ln Suite 109 Arlington Heights IL 60005-5023 | |
(847) 368-3200 | |
(847) 368-7808 |
Full Name | Davenport Chiropractic Wellness Center Pc |
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Speciality | Clinic/Center |
Location | 3350 W Salt Creek Ln, Arlington Heights, Illinois |
Authorized Official Name and Position | Michael P Davenport (OWNER/PROVIDER) |
Authorized Official Contact | 8473683200 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Davenport Chiropractic Wellness Center Pc 3350 W Salt Creek Ln Suite 109 Arlington Heights IL 60005-5023 Ph: (847) 368-3200 | Davenport Chiropractic Wellness Center Pc 3350 W Salt Creek Ln Suite 109 Arlington Heights IL 60005-5023 Ph: (847) 368-3200 |
NPI Number | 1790970390 |
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Provider Enumeration Date | 09/07/2007 |
Last Update Date | 09/07/2007 |
Medicare PECOS PAC ID | 4981790532 |
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Medicare Enrollment ID | O20071012000533 |
Identifier | Type | State | Issuer |
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1790970390 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (Illinois) | Primary |
Provider Name | Charles C Wood |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1316085970 PECOS PAC ID: 1254362304 Enrollment ID: I20050829000259 |
Provider Name | Ryan D Hamm |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1083642623 PECOS PAC ID: 5597829002 Enrollment ID: I20090128000366 |
Provider Name | Mariann Leahy |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1851436042 PECOS PAC ID: 0840414132 Enrollment ID: I20140605002216 |
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