Provider Demographics
NPI:1497228746
Name:RUNYAN CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:RUNYAN CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUNYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-691-2727
Mailing Address - Street 1:274 COMSTOCK DR
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60124-3811
Mailing Address - Country:US
Mailing Address - Phone:847-691-2727
Mailing Address - Fax:
Practice Address - Street 1:1607 E MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-2390
Practice Address - Country:US
Practice Address - Phone:331-222-9667
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-09
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty