Provider Demographics
NPI:1790173730
Name:MUSCLE HEALTH LLC
Entity Type:Organization
Organization Name:MUSCLE HEALTH LLC
Other - Org Name:CHICAGO CENTER FOR MYOFASCIAL PAIN RELIEF
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BIANCALANA
Authorized Official - Suffix:
Authorized Official - Credentials:CMTPT, LMT, CPT
Authorized Official - Phone:773-628-7654
Mailing Address - Street 1:6304 N NAGLE AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-3614
Mailing Address - Country:US
Mailing Address - Phone:773-628-7654
Mailing Address - Fax:
Practice Address - Street 1:6304 N NAGLE AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-3614
Practice Address - Country:US
Practice Address - Phone:773-628-7654
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-29
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227.000301174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty