Provider Demographics
NPI:1861638991
Name:ACCELERATED SPORTS PERFORMANCE CENTERS, INC.
Entity Type:Organization
Organization Name:ACCELERATED SPORTS PERFORMANCE CENTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:DIVYA
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:312-402-0081
Mailing Address - Street 1:195 N HARBOR DR
Mailing Address - Street 2:UNIT 2908
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-7514
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:195 N HARBOR DR
Practice Address - Street 2:UNIT 2908
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7514
Practice Address - Country:US
Practice Address - Phone:312-402-0081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-18
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-009825111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty