Provider Demographics
NPI:1700051786
Name:MCKENNA CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:MCKENNA CHIROPRACTIC, LLC
Other - Org Name:ESSENTIAL CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:RORY
Authorized Official - Middle Name:O'NEILL
Authorized Official - Last Name:MCKENNA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:708-233-0022
Mailing Address - Street 1:7229 WEST 103RD STREET
Mailing Address - Street 2:
Mailing Address - City:PALOS HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60465
Mailing Address - Country:US
Mailing Address - Phone:708-233-0022
Mailing Address - Fax:
Practice Address - Street 1:7229 W 103RD ST
Practice Address - Street 2:
Practice Address - City:PALOS HILLS
Practice Address - State:IL
Practice Address - Zip Code:60465-2064
Practice Address - Country:US
Practice Address - Phone:646-373-5874
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010541111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty