Provider Demographics
NPI:1619166873
Name:SKYPOINT CHIROPRACTIC & ACUPUNCTURE SC
Entity Type:Organization
Organization Name:SKYPOINT CHIROPRACTIC & ACUPUNCTURE SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:WONG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-387-9452
Mailing Address - Street 1:2112 WINDING RIVER DR STE 120
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-8555
Mailing Address - Country:US
Mailing Address - Phone:847-387-9452
Mailing Address - Fax:
Practice Address - Street 1:2112 WINDING RIVER DR STE 120
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-8555
Practice Address - Country:US
Practice Address - Phone:847-387-9452
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-23
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty