Provider Demographics
NPI:1912027624
Name:NORTH MICHIGAN AVENUE CHIROPRACTIC
Entity Type:Organization
Organization Name:NORTH MICHIGAN AVENUE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR, OWNER, PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:SCHULZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:312-372-2411
Mailing Address - Street 1:333 N MICHIGAN AVE
Mailing Address - Street 2:SUITE 1030
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-3901
Mailing Address - Country:US
Mailing Address - Phone:312-372-2411
Mailing Address - Fax:312-276-4959
Practice Address - Street 1:333 N MICHIGAN AVE STE 901
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-3735
Practice Address - Country:US
Practice Address - Phone:312-372-2411
Practice Address - Fax:312-276-4959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010499111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1093795833OtherINDIVIDUAL PROVIDER'S NPI
IL696586OtherINDIVIDUAL ACN NUMBER
IL696585OtherINDIVIDUAL ACN NUMBER
IL0001635893OtherBCBS OF IL GROUP NUMBER
IL1639159171OtherINDIVIDUAL PROVIDER'S NPI
IL696586OtherINDIVIDUAL ACN NUMBER
IL696585OtherINDIVIDUAL ACN NUMBER
IL1639159171OtherINDIVIDUAL PROVIDER'S NPI