Provider Demographics
NPI:1457320947
Name:TRAGER HEALING CENTER LTD
Entity Type:Organization
Organization Name:TRAGER HEALING CENTER LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-717-5060
Mailing Address - Street 1:29 S WEBSTER ST
Mailing Address - Street 2:SUITE 290
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-5356
Mailing Address - Country:US
Mailing Address - Phone:630-717-5060
Mailing Address - Fax:630-717-5122
Practice Address - Street 1:29 S WEBSTER ST
Practice Address - Street 2:SUITE 290
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-5356
Practice Address - Country:US
Practice Address - Phone:630-717-5060
Practice Address - Fax:630-717-5122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-16
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038007289111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL350050896OtherRR MEDICARE
U49365Medicare UPIN
IL213697Medicare PIN