Provider Demographics
NPI:1407207129
Name:INTEGRATED HOLISTIC HEALTHCARE, S.C.
Entity Type:Organization
Organization Name:INTEGRATED HOLISTIC HEALTHCARE, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-251-0044
Mailing Address - Street 1:522 POPLAR DR
Mailing Address - Street 2:
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-2717
Mailing Address - Country:US
Mailing Address - Phone:847-251-0044
Mailing Address - Fax:847-251-0066
Practice Address - Street 1:522 POPLAR DR
Practice Address - Street 2:
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091-2717
Practice Address - Country:US
Practice Address - Phone:847-251-0044
Practice Address - Fax:847-251-0066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012966111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty