Provider Demographics
NPI:1740577923
Name:ORLAND CHIROPRACTIC AND PHYSICAL MEDICINE, LLC
Entity Type:Organization
Organization Name:ORLAND CHIROPRACTIC AND PHYSICAL MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RASHID
Authorized Official - Middle Name:
Authorized Official - Last Name:ABU-SHANAB
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:708-949-8401
Mailing Address - Street 1:14406 JOHN HUMPHREY DR
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-2638
Mailing Address - Country:US
Mailing Address - Phone:708-949-8401
Mailing Address - Fax:708-949-8497
Practice Address - Street 1:14406 JOHN HUMPHREY DR
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-2638
Practice Address - Country:US
Practice Address - Phone:708-949-8401
Practice Address - Fax:708-949-8497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-07
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038008510111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty