Provider Demographics
NPI:1902045743
Name:CHANDLER MEDICAL GROUP
Entity Type:Organization
Organization Name:CHANDLER MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MISS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:M
Authorized Official - Last Name:SALAJKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-267-9500
Mailing Address - Street 1:4340 E INDIAN SCHOOL RD
Mailing Address - Street 2:SUITE 21-540
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-5360
Mailing Address - Country:US
Mailing Address - Phone:602-267-9500
Mailing Address - Fax:602-865-1527
Practice Address - Street 1:2633 E INDIAN SCHOOL RD
Practice Address - Street 2:SUITE 130
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-6759
Practice Address - Country:US
Practice Address - Phone:602-267-9500
Practice Address - Fax:602-865-1527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-18
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty