Provider Demographics
NPI:1063828309
Name:PATRICK LABELLE DC SC
Entity Type:Organization
Organization Name:PATRICK LABELLE DC SC
Other - Org Name:BIOMECHANICS SPORTS REHABILITATION AND CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:LABELLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:773-472-0700
Mailing Address - Street 1:1255 W DIVERSEY PKWY
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1201
Mailing Address - Country:US
Mailing Address - Phone:773-472-0700
Mailing Address - Fax:773-337-9106
Practice Address - Street 1:1255 W DIVERSEY PKWY
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-1201
Practice Address - Country:US
Practice Address - Phone:773-472-0700
Practice Address - Fax:773-337-9106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-08
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010074111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty