Provider Demographics
NPI:1265852883
Name:ALLOY PHYSICAL CARE INSTITUTE LTD
Entity Type:Organization
Organization Name:ALLOY PHYSICAL CARE INSTITUTE LTD
Other - Org Name:ALLOY PHYSICAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:SEBASTIAN
Authorized Official - Last Name:MOZDZIEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:708-769-0910
Mailing Address - Street 1:4830 N CUMBERLAND AVE
Mailing Address - Street 2:SUITE 9
Mailing Address - City:NORRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60706-2966
Mailing Address - Country:US
Mailing Address - Phone:708-453-0064
Mailing Address - Fax:
Practice Address - Street 1:4830 N CUMBERLAND AVE
Practice Address - Street 2:SUITE 9
Practice Address - City:NORRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60706-2966
Practice Address - Country:US
Practice Address - Phone:708-453-0064
Practice Address - Fax:708-452-0904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-22
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012596111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty