Provider Demographics
NPI:1083820559
Name:CHICAGO NECK & BACK INSTITUTE LTD. PC
Entity Type:Organization
Organization Name:CHICAGO NECK & BACK INSTITUTE LTD. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:G
Authorized Official - Last Name:JUNGHEIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-237-8660
Mailing Address - Street 1:5700 W FULLERTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60639-2307
Mailing Address - Country:US
Mailing Address - Phone:773-237-8660
Mailing Address - Fax:
Practice Address - Street 1:5700 W FULLERTON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60639-2307
Practice Address - Country:US
Practice Address - Phone:773-237-8660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty