Provider Demographics
NPI:1790805828
Name:TAYLOR CHIROPRACTIC, S.C.
Entity Type:Organization
Organization Name:TAYLOR CHIROPRACTIC, S.C.
Other - Org Name:TAYLOR REHAB AND WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ARON
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:773-725-5835
Mailing Address - Street 1:PO BOX 411293
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-1293
Mailing Address - Country:US
Mailing Address - Phone:773-725-5835
Mailing Address - Fax:773-725-5834
Practice Address - Street 1:102 W ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:VILLA PARK
Practice Address - State:IL
Practice Address - Zip Code:60181-3504
Practice Address - Country:US
Practice Address - Phone:630-832-3035
Practice Address - Fax:630-832-1481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL03810904111N00000X
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty