Provider Demographics
NPI:1235667288
Name:PLANET CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:PLANET CHIROPRACTIC LLC
Other - Org Name:PLANET CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MOYNIHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-372-0170
Mailing Address - Street 1:432 N WEBER RD
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446-4945
Mailing Address - Country:US
Mailing Address - Phone:815-372-0170
Mailing Address - Fax:815-372-0171
Practice Address - Street 1:432 N WEBER RD
Practice Address - Street 2:
Practice Address - City:ROMEOVILLE
Practice Address - State:IL
Practice Address - Zip Code:60446-4945
Practice Address - Country:US
Practice Address - Phone:815-372-0170
Practice Address - Fax:815-372-0171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-02
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012185111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty