Provider Demographics
NPI:1093922445
Name:FLOW CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:FLOW CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:AARDEMA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:708-386-9886
Mailing Address - Street 1:1515 N HARLEM AVE.
Mailing Address - Street 2:SUITE 301
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-1205
Mailing Address - Country:US
Mailing Address - Phone:708-386-9886
Mailing Address - Fax:
Practice Address - Street 1:1515 N HARLEM AVE.
Practice Address - Street 2:SUITE 301
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-1205
Practice Address - Country:US
Practice Address - Phone:708-386-9886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILV04445Medicare UPIN
IL211333Medicare ID - Type Unspecified