Provider Demographics
NPI:1851008536
Name:ULF HENRICSSON SPORTS AND HEALTH CLINIC
Entity Type:Organization
Organization Name:ULF HENRICSSON SPORTS AND HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ULF
Authorized Official - Middle Name:RIKARD
Authorized Official - Last Name:HENRICSSON
Authorized Official - Suffix:
Authorized Official - Credentials:DOCTOR OF NAPRAPATHY
Authorized Official - Phone:312-661-0660
Mailing Address - Street 1:101 W GRAND AVE STE 402
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-7129
Mailing Address - Country:US
Mailing Address - Phone:312-661-0660
Mailing Address - Fax:708-991-9003
Practice Address - Street 1:101 W GRAND AVE STE 402
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-7129
Practice Address - Country:US
Practice Address - Phone:312-661-0660
Practice Address - Fax:708-991-9003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172P00000XOther Service ProvidersNaprapathGroup - Multi-Specialty