Provider Demographics
NPI:1508002692
Name:ACCELERATED SPORTS PERFORMANCE CENTERS
Entity Type:Organization
Organization Name:ACCELERATED SPORTS PERFORMANCE CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DIVYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:312-402-0081
Mailing Address - Street 1:195 N HARBOR DR
Mailing Address - Street 2:SUITE #2908
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-7514
Mailing Address - Country:US
Mailing Address - Phone:312-402-0081
Mailing Address - Fax:
Practice Address - Street 1:2202 N LINCOLN AVE
Practice Address - Street 2:SUITE #2
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-7170
Practice Address - Country:US
Practice Address - Phone:312-402-0081
Practice Address - Fax:312-552-0010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-19
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty