Provider Demographics
NPI:1669661567
Name:CHIRO CARE INC
Entity Type:Organization
Organization Name:CHIRO CARE INC
Other - Org Name:SOUTHWEST CHIROPRACTIC & REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:WOSS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:773-582-7677
Mailing Address - Street 1:PO BOX 388819
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-8819
Mailing Address - Country:US
Mailing Address - Phone:773-582-7677
Mailing Address - Fax:773-582-8477
Practice Address - Street 1:5839 S ARCHER AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638-1619
Practice Address - Country:US
Practice Address - Phone:773-582-7677
Practice Address - Fax:773-582-8477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-17
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038005948261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL999380Medicare PIN