Provider Demographics
NPI:1043500309
Name:ALLERGIES, ACHES & PAINS CHIRO & ACCUPUNCTURE CENTER LTD
Entity Type:Organization
Organization Name:ALLERGIES, ACHES & PAINS CHIRO & ACCUPUNCTURE CENTER LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:MELTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:815-895-2059
Mailing Address - Street 1:130 FAIR ST
Mailing Address - Street 2:
Mailing Address - City:SYCAMORE
Mailing Address - State:IL
Mailing Address - Zip Code:60178-1640
Mailing Address - Country:US
Mailing Address - Phone:815-895-2059
Mailing Address - Fax:815-895-2329
Practice Address - Street 1:130 FAIR ST
Practice Address - Street 2:
Practice Address - City:SYCAMORE
Practice Address - State:IL
Practice Address - Zip Code:60178-1640
Practice Address - Country:US
Practice Address - Phone:815-895-2059
Practice Address - Fax:815-895-2329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-07
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL38008696111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty