Provider Demographics
NPI:1487660957
Name:CHIRO-CENTER PC
Entity Type:Organization
Organization Name:CHIRO-CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF SHAREHOLDER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-665-8688
Mailing Address - Street 1:55 E LOOP RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-1938
Mailing Address - Country:US
Mailing Address - Phone:630-665-8688
Mailing Address - Fax:630-665-4705
Practice Address - Street 1:55 E LOOP RD
Practice Address - Street 2:SUITE 203
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60189-1938
Practice Address - Country:US
Practice Address - Phone:630-665-8688
Practice Address - Fax:630-665-4705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038006130111N00000X
IL038006731111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty