Provider Demographics
NPI:1790975472
Name:CAPRI CHIROPRACTIC CARE LTD
Entity Type:Organization
Organization Name:CAPRI CHIROPRACTIC CARE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VON BERGEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-382-2770
Mailing Address - Street 1:28662 W NORTHWEST HWY
Mailing Address - Street 2:STE 4
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-5928
Mailing Address - Country:US
Mailing Address - Phone:847-382-2770
Mailing Address - Fax:847-382-2796
Practice Address - Street 1:28662 W NORTHWEST HWY
Practice Address - Street 2:STE 4
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-5928
Practice Address - Country:US
Practice Address - Phone:847-382-2770
Practice Address - Fax:847-382-2796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-27
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL060005175111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4982060OtherBCBSIL
IL759170Medicare PIN