Provider Demographics
NPI:1649599945
Name:FAMILY CHIROPRACTOR, INC
Entity Type:Organization
Organization Name:FAMILY CHIROPRACTOR, INC
Other - Org Name:FAMILY CHIROPRACTOR, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:HORAK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-362-8882
Mailing Address - Street 1:706 S BUTTERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-9458
Mailing Address - Country:US
Mailing Address - Phone:847-362-8882
Mailing Address - Fax:847-362-8889
Practice Address - Street 1:706 S BUTTERFIELD RD
Practice Address - Street 2:
Practice Address - City:MUNDELEIN
Practice Address - State:IL
Practice Address - Zip Code:60060-9458
Practice Address - Country:US
Practice Address - Phone:847-362-8882
Practice Address - Fax:847-362-8889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-26
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038006188111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty