Provider Demographics
NPI:1447572052
Name:ATLAS FAMILY CHIROPRACTIC AND WELLNESS CENTER
Entity Type:Organization
Organization Name:ATLAS FAMILY CHIROPRACTIC AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:DZIURGOT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-849-9417
Mailing Address - Street 1:1407 N RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-4606
Mailing Address - Country:US
Mailing Address - Phone:847-849-9417
Mailing Address - Fax:
Practice Address - Street 1:1407 N RIDGE AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-4606
Practice Address - Country:US
Practice Address - Phone:847-849-9417
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011571111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty