Provider Demographics
NPI:1225049745
Name:NORTHBROOK CHIROPRACTIC
Entity Type:Organization
Organization Name:NORTHBROOK CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:KEIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-557-2981
Mailing Address - Street 1:970 N COIT RD
Mailing Address - Street 2:SUITE 3095A
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-5416
Mailing Address - Country:US
Mailing Address - Phone:214-366-9800
Mailing Address - Fax:214-366-9802
Practice Address - Street 1:970 N COIT RD
Practice Address - Street 2:SUITE 3095A
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-5416
Practice Address - Country:US
Practice Address - Phone:214-366-9800
Practice Address - Fax:214-366-9802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty