Provider Demographics
NPI:1417363961
Name:TRIGGER POINT TREATMENT CENTER OF CHICAGO LLC
Entity Type:Organization
Organization Name:TRIGGER POINT TREATMENT CENTER OF CHICAGO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/TRIGGER POINT THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:CMTPT, LMT
Authorized Official - Phone:773-263-3491
Mailing Address - Street 1:1150 N STATE ST
Mailing Address - Street 2:C315
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-7481
Mailing Address - Country:US
Mailing Address - Phone:773-263-3491
Mailing Address - Fax:
Practice Address - Street 1:1150 N STATE ST
Practice Address - Street 2:C315
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-7481
Practice Address - Country:US
Practice Address - Phone:773-263-3491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-05
Last Update Date:2014-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227.016025174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty