Provider Demographics
NPI:1487822508
Name:MIDWEST INTEGRATED HEALTHCARE, S.C.
Entity Type:Organization
Organization Name:MIDWEST INTEGRATED HEALTHCARE, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-346-2545
Mailing Address - Street 1:1888 BAY SCOTT CIR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-1106
Mailing Address - Country:US
Mailing Address - Phone:630-888-1878
Mailing Address - Fax:630-305-0311
Practice Address - Street 1:1888 BAY SCOTT CIR
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-1106
Practice Address - Country:US
Practice Address - Phone:630-888-1878
Practice Address - Fax:630-305-0311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.010267111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty