Provider Demographics
NPI:1790894301
Name:ADJUSTED HEALTH CHIROPRACTIC S.C.
Entity Type:Organization
Organization Name:ADJUSTED HEALTH CHIROPRACTIC S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:ANGELA
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-428-0768
Mailing Address - Street 1:1603 N AURORA RD STE 111
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-1882
Mailing Address - Country:US
Mailing Address - Phone:630-428-0768
Mailing Address - Fax:630-428-2293
Practice Address - Street 1:1603 N AURORA RD
Practice Address - Street 2:STE 111
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-1869
Practice Address - Country:US
Practice Address - Phone:630-428-0768
Practice Address - Fax:630-428-2293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038009662111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
K06325Medicare ID - Type Unspecified
208954Medicare ID - Type Unspecified