Provider Demographics
NPI:1306204268
Name:ABSOLUTE BODY CARE
Entity Type:Organization
Organization Name:ABSOLUTE BODY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:MINSOOK
Authorized Official - Middle Name:D
Authorized Official - Last Name:KROON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:700-000-0000
Mailing Address - Street 1:5012 N TRIPP AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-2725
Mailing Address - Country:US
Mailing Address - Phone:700-000-0000
Mailing Address - Fax:773-945-9341
Practice Address - Street 1:8 SOUTH MICHIGAN AVENUE
Practice Address - Street 2:SUITE 2020
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60603-5520
Practice Address - Country:US
Practice Address - Phone:700-000-0000
Practice Address - Fax:773-945-9341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-08
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011066111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1063679348OtherNPI