Provider Demographics
NPI:1689351801
Name:ORIENTAL CHIROPRACTIC 2 LLC
Entity Type:Organization
Organization Name:ORIENTAL CHIROPRACTIC 2 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KYONGSOCK
Authorized Official - Middle Name:
Authorized Official - Last Name:OH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-514-2034
Mailing Address - Street 1:1891 BAY SCOTT CIR STE 115
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-1138
Mailing Address - Country:US
Mailing Address - Phone:630-364-2302
Mailing Address - Fax:
Practice Address - Street 1:1891 BAY SCOTT CIR STE 115
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-1138
Practice Address - Country:US
Practice Address - Phone:630-364-2302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty