Provider Demographics
NPI:1477758092
Name:ANEW CHIROPRACTIC & PHYSICAL THERAPY S C
Entity Type:Organization
Organization Name:ANEW CHIROPRACTIC & PHYSICAL THERAPY S C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:RUBIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:815-207-7463
Mailing Address - Street 1:115 REPUBLIC AVE
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-6515
Mailing Address - Country:US
Mailing Address - Phone:815-207-7463
Mailing Address - Fax:
Practice Address - Street 1:115 REPUBLIC AVE
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6515
Practice Address - Country:US
Practice Address - Phone:815-207-7463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-15
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010952111N00000X
IL122300000X
IL0360788262081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty