Provider Demographics
NPI:1750649687
Name:VITALITY 4U2 CHIROPRACTIC CARE FOR THE WHOLE FAMILY, P.C.
Entity Type:Organization
Organization Name:VITALITY 4U2 CHIROPRACTIC CARE FOR THE WHOLE FAMILY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:PEPPERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-842-1968
Mailing Address - Street 1:2215 N 72ND CT
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60707-2722
Mailing Address - Country:US
Mailing Address - Phone:630-842-1968
Mailing Address - Fax:
Practice Address - Street 1:345A W OGDEN AVE
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-1419
Practice Address - Country:US
Practice Address - Phone:630-842-1968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-28
Last Update Date:2012-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.012098111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty