Provider Demographics
NPI:1063031003
Name:BAZAN'S HEALTH CENTER INC
Entity Type:Organization
Organization Name:BAZAN'S HEALTH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DELTON
Authorized Official - Middle Name:
Authorized Official - Last Name:BAZAN-PECHE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-452-3889
Mailing Address - Street 1:6001 S KEATING AVE # 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60629-5409
Mailing Address - Country:US
Mailing Address - Phone:630-452-3889
Mailing Address - Fax:773-498-6596
Practice Address - Street 1:4012 W 63RD ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60629-4606
Practice Address - Country:US
Practice Address - Phone:773-306-1928
Practice Address - Fax:773-498-6596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-09
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty