Provider Demographics
NPI:1093045114
Name:ALEVIO PHYSICAL THERAPHY AND CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:ALEVIO PHYSICAL THERAPHY AND CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BERMUDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:312-337-6072
Mailing Address - Street 1:1150 N STATE ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-7481
Mailing Address - Country:US
Mailing Address - Phone:312-337-6072
Mailing Address - Fax:312-337-3163
Practice Address - Street 1:1150 N STATE ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-7481
Practice Address - Country:US
Practice Address - Phone:312-337-6072
Practice Address - Fax:312-337-3163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-12
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty