Provider Demographics
NPI:1689157869
Name:MEYSTER CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:MEYSTER CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VITALIY
Authorized Official - Middle Name:S
Authorized Official - Last Name:MEYSTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-400-8109
Mailing Address - Street 1:906 LACEY AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-4373
Mailing Address - Country:US
Mailing Address - Phone:708-762-8776
Mailing Address - Fax:
Practice Address - Street 1:906 LACEY AVE STE 100
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-4373
Practice Address - Country:US
Practice Address - Phone:708-762-8776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty