Provider Demographics
NPI:1326186594
Name:LARCHER CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:LARCHER CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:V
Authorized Official - Last Name:LARCHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC FACO
Authorized Official - Phone:708-799-6700
Mailing Address - Street 1:PO BOX 1608
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-0608
Mailing Address - Country:US
Mailing Address - Phone:708-799-6700
Mailing Address - Fax:708-799-6102
Practice Address - Street 1:18216 HARWOOD AVE
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-2144
Practice Address - Country:US
Practice Address - Phone:708-799-6700
Practice Address - Fax:708-799-6102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X, 111NR0400X, 111NS0005X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Not Answered111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Not Answered111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Not Answered111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL662770Medicare ID - Type Unspecified
ILT37603Medicare UPIN