Provider Demographics
NPI:1033301775
Name:HIMLEY CHIROPRACTIC, LTD
Entity Type:Organization
Organization Name:HIMLEY CHIROPRACTIC, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:HIMLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-658-4900
Mailing Address - Street 1:265 STONEGATE RD
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-5614
Mailing Address - Country:US
Mailing Address - Phone:847-658-4900
Mailing Address - Fax:847-658-8306
Practice Address - Street 1:265 STONEGATE RD
Practice Address - Street 2:
Practice Address - City:ALGONQUIN
Practice Address - State:IL
Practice Address - Zip Code:60102-5614
Practice Address - Country:US
Practice Address - Phone:847-658-4900
Practice Address - Fax:847-658-8306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1275631061OtherTYPE 1 NPI
IL056-06317OtherBLUE CROSS ID
IL056-06317OtherBLUE CROSS ID
ILK18464Medicare UPIN