Provider Demographics
NPI:1467771261
Name:PRYCHITKO, AMY NICOLE (DC)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:NICOLE
Last Name:PRYCHITKO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 S WELLS ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-4529
Mailing Address - Country:US
Mailing Address - Phone:312-765-0411
Mailing Address - Fax:
Practice Address - Street 1:800 S WELLS ST
Practice Address - Street 2:SUITE 150
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-4529
Practice Address - Country:US
Practice Address - Phone:312-765-0411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-19
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011694111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor