Provider Demographics
NPI:1518192335
Name:CONCEPT CARE CHIROPRACTIC AND WELLNESS CENTER SC
Entity Type:Organization
Organization Name:CONCEPT CARE CHIROPRACTIC AND WELLNESS CENTER SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:KIRK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-960-9914
Mailing Address - Street 1:6230 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60516-1908
Mailing Address - Country:US
Mailing Address - Phone:630-960-9914
Mailing Address - Fax:630-960-9924
Practice Address - Street 1:6230 MAIN ST
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60516-1908
Practice Address - Country:US
Practice Address - Phone:630-960-9914
Practice Address - Fax:630-960-9924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-22
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty