Provider Demographics
NPI:1225236714
Name:PRECISE CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:PRECISE CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SEBASTIAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:FUKSA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-666-6888
Mailing Address - Street 1:4581 PRINCETON LANE
Mailing Address - Street 2:SUITE 119
Mailing Address - City:LAKE IN THE HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60156
Mailing Address - Country:US
Mailing Address - Phone:847-669-6888
Mailing Address - Fax:847-669-8203
Practice Address - Street 1:4581 PRINCETON LANE
Practice Address - Street 2:SUITE 119
Practice Address - City:LAKE IN THE HILLS
Practice Address - State:IL
Practice Address - Zip Code:60156
Practice Address - Country:US
Practice Address - Phone:847-669-6888
Practice Address - Fax:847-669-8203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-05
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-009936111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL05632177OtherBCBS IL
IL213365Medicare PIN