Provider Demographics
NPI:1083828230
Name:INTEGRATIVE HEALTH ASSOCIATES, LTD
Entity Type:Organization
Organization Name:INTEGRATIVE HEALTH ASSOCIATES, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RASHID
Authorized Official - Middle Name:A
Authorized Official - Last Name:ABU-SHANAB
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:815-293-3000
Mailing Address - Street 1:600 S WEBER RD
Mailing Address - Street 2:SUITE 9A
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446-5064
Mailing Address - Country:US
Mailing Address - Phone:815-293-3000
Mailing Address - Fax:815-372-9500
Practice Address - Street 1:600 S WEBER RD
Practice Address - Street 2:SUITE 9A
Practice Address - City:ROMEOVILLE
Practice Address - State:IL
Practice Address - Zip Code:60446-5064
Practice Address - Country:US
Practice Address - Phone:815-293-3000
Practice Address - Fax:815-372-9500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038008510111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL038008510Medicaid
IL09932115OtherBCBS
IL7562505OtherAETNA
IL038008510Medicaid
IL208623Medicare ID - Type Unspecified