Provider Demographics
NPI:1164844452
Name:NATURAL CHIORPRPRATIC SOLUTIONS LLC
Entity Type:Organization
Organization Name:NATURAL CHIORPRPRATIC SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-778-5140
Mailing Address - Street 1:11950 S HARLEM AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1150
Mailing Address - Country:US
Mailing Address - Phone:224-778-5140
Mailing Address - Fax:877-575-6373
Practice Address - Street 1:11950 S HARLEM AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1150
Practice Address - Country:US
Practice Address - Phone:224-778-5140
Practice Address - Fax:877-575-6373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-06
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.011347111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty