Provider Demographics
NPI:1619268489
Name:WELL ADJUSTED WORLD
Entity Type:Organization
Organization Name:WELL ADJUSTED WORLD
Other - Org Name:WELL ADJUSTED MOTHER & CHILD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MANNING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:708-848-4940
Mailing Address - Street 1:715 LAKE ST
Mailing Address - Street 2:SUITE 271
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60301-1422
Mailing Address - Country:US
Mailing Address - Phone:708-848-4940
Mailing Address - Fax:708-848-4941
Practice Address - Street 1:715 LAKE ST
Practice Address - Street 2:SUITE 271
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1422
Practice Address - Country:US
Practice Address - Phone:708-848-4940
Practice Address - Fax:708-848-4941
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WELL ADJUSTED WORLD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-008898111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty