Provider Demographics
NPI:1164647442
Name:DISCOVER CHIROPRACTIC HEALTH CENTER LTD
Entity Type:Organization
Organization Name:DISCOVER CHIROPRACTIC HEALTH CENTER LTD
Other - Org Name:DISCOVER CHIROPRACTIC & ACUPUNCTURE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DARRIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:FOSZCZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:815-675-9355
Mailing Address - Street 1:2207 N US HIGHWAY 12
Mailing Address - Street 2:SUITE E
Mailing Address - City:SPRING GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60081-9706
Mailing Address - Country:US
Mailing Address - Phone:815-675-9355
Mailing Address - Fax:815-975-9323
Practice Address - Street 1:2207 N US HIGHWAY 12
Practice Address - Street 2:SUITE E
Practice Address - City:SPRING GROVE
Practice Address - State:IL
Practice Address - Zip Code:60081-9706
Practice Address - Country:US
Practice Address - Phone:815-675-9355
Practice Address - Fax:815-975-9323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038008496111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL7654372OtherAETNA
IL04932017OtherBCBS
IL7654372OtherAETNA
IL04932017OtherBCBS