Provider Demographics
NPI:1750629549
Name:KAIZEN CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:KAIZEN CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:QANI
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSHANI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-865-3479
Mailing Address - Street 1:77 W WASHINGTON ST
Mailing Address - Street 2:#1704
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-2801
Mailing Address - Country:US
Mailing Address - Phone:630-865-3479
Mailing Address - Fax:312-977-2101
Practice Address - Street 1:77 W WASHINGTON ST
Practice Address - Street 2:#1704
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-2801
Practice Address - Country:US
Practice Address - Phone:312-977-2100
Practice Address - Fax:312-977-2101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-29
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012282111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty