Provider Demographics
NPI:1114105301
Name:MEI CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:MEI CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HUBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MEI
Authorized Official - Suffix:
Authorized Official - Credentials:DC LAC DABCO
Authorized Official - Phone:312-225-6434
Mailing Address - Street 1:467 W 31ST ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-3135
Mailing Address - Country:US
Mailing Address - Phone:321-225-6434
Mailing Address - Fax:
Practice Address - Street 1:467 W 31ST ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-3135
Practice Address - Country:US
Practice Address - Phone:321-225-6434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-10
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038007401261Q00000X
IL198.000230261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL016-388-25OtherBLUE CROSS / BLUE SHIELD
IL016-388-25OtherBLUE CROSS / BLUE SHIELD