Provider Demographics
NPI:1457681397
Name:HAWKEYE CHIROPRACTIC CLINIC INC.
Entity Type:Organization
Organization Name:HAWKEYE CHIROPRACTIC CLINIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:MONSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-472-1224
Mailing Address - Street 1:1401 S ARLINGTON HEIGHTS RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ARLINGTON HTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-3700
Mailing Address - Country:US
Mailing Address - Phone:847-472-1224
Mailing Address - Fax:
Practice Address - Street 1:1401 S ARLINGTON HEIGHTS RD
Practice Address - Street 2:SUITE 2
Practice Address - City:ARLINGTON HTS
Practice Address - State:IL
Practice Address - Zip Code:60005-3700
Practice Address - Country:US
Practice Address - Phone:847-472-1224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-27
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011141261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL 2944OtherPTAN