Provider Demographics
NPI:1457473944
Name:BARTLETT CHIROPRACTIC DBA DOCTORS' CENTER FOR INTEGRATIVE WELLNESS
Entity Type:Organization
Organization Name:BARTLETT CHIROPRACTIC DBA DOCTORS' CENTER FOR INTEGRATIVE WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:BARTLETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-960-9355
Mailing Address - Street 1:1045 BURLINGTON AVE
Mailing Address - Street 2:#1
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-1887
Mailing Address - Country:US
Mailing Address - Phone:630-960-9355
Mailing Address - Fax:630-960-9392
Practice Address - Street 1:1045 BURLINGTON AVE
Practice Address - Street 2:#1
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-1887
Practice Address - Country:US
Practice Address - Phone:630-960-9355
Practice Address - Fax:630-960-9392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL3610727OtherCIGNA PROVIDER NUMBER
IL7957448OtherAETNA PROVIDER NUMBER
IL11562742OtherCAQH PROVIDER NUMBER
IL02232594OtherBCBS PROVIDER NUMBER
IL697284OtherACN PROVIDER NUMBER
ILU99565Medicare UPIN
IL11562742OtherCAQH PROVIDER NUMBER