Provider Demographics
NPI:1740584622
Name:NORTH SHORE NATURAL MEDICINE INC.
Entity Type:Organization
Organization Name:NORTH SHORE NATURAL MEDICINE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:ZIMRING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:217-816-6678
Mailing Address - Street 1:378 PARK AVE
Mailing Address - Street 2:SUITE 1D
Mailing Address - City:GLENCOE
Mailing Address - State:IL
Mailing Address - Zip Code:60022-1586
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:847-563-1330
Practice Address - Street 1:378 PARK AVE
Practice Address - Street 2:SUITE 1D
Practice Address - City:GLENCOE
Practice Address - State:IL
Practice Address - Zip Code:60022-1586
Practice Address - Country:US
Practice Address - Phone:217-816-6678
Practice Address - Fax:847-563-1330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011848111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty