Provider Demographics
NPI:1093059107
Name:RIVER POINT NATURAL HEALTH
Entity Type:Organization
Organization Name:RIVER POINT NATURAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:AVANI
Authorized Official - Middle Name:A
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:D C
Authorized Official - Phone:650-678-5669
Mailing Address - Street 1:400 N MCCLURG CT
Mailing Address - Street 2:2206
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4323
Mailing Address - Country:US
Mailing Address - Phone:650-678-5669
Mailing Address - Fax:
Practice Address - Street 1:2435 N ASHLAND AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-2032
Practice Address - Country:US
Practice Address - Phone:773-929-4343
Practice Address - Fax:773-929-9184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011605111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Single Specialty