Provider Demographics
NPI:1376165712
Name:PATIE LLC
Entity Type:Organization
Organization Name:PATIE LLC
Other - Org Name:ARC HOLISTIC MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER/CO-CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NIEBUR
Authorized Official - Suffix:
Authorized Official - Credentials:ND, DC
Authorized Official - Phone:708-362-2337
Mailing Address - Street 1:533 W NORTH AVE
Mailing Address - Street 2:#LL50
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126
Mailing Address - Country:US
Mailing Address - Phone:630-501-1093
Mailing Address - Fax:
Practice Address - Street 1:533 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-2910
Practice Address - Country:US
Practice Address - Phone:630-501-1093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-07
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty