Provider Demographics
NPI:1508165614
Name:CHICAGO HEALTH PARTNERS, LLC
Entity Type:Organization
Organization Name:CHICAGO HEALTH PARTNERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR. / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MISHA
Authorized Official - Middle Name:JOSEF
Authorized Official - Last Name:PAYANT
Authorized Official - Suffix:
Authorized Official - Credentials:DAC
Authorized Official - Phone:773-746-9933
Mailing Address - Street 1:356 W SUPERIOR ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-3416
Mailing Address - Country:US
Mailing Address - Phone:773-746-9933
Mailing Address - Fax:
Practice Address - Street 1:356 W SUPERIOR ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-3416
Practice Address - Country:US
Practice Address - Phone:773-746-9933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-15
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038004928111N00000X
RIDA00369171100000X
IL198000961171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty