Provider Demographics
NPI:1265630271
Name:HORIZON CHIROPRACTIC, SC
Entity Type:Organization
Organization Name:HORIZON CHIROPRACTIC, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:HALLUM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-658-8541
Mailing Address - Street 1:43 W ACORN LN
Mailing Address - Street 2:
Mailing Address - City:LAKE IN THE HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60156-4804
Mailing Address - Country:US
Mailing Address - Phone:847-658-8541
Mailing Address - Fax:847-658-7395
Practice Address - Street 1:43 W ACORN LN
Practice Address - Street 2:
Practice Address - City:LAKE IN THE HILLS
Practice Address - State:IL
Practice Address - Zip Code:60156-4804
Practice Address - Country:US
Practice Address - Phone:847-658-8541
Practice Address - Fax:847-658-7395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL042.618598111N00000X
261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty