Provider Demographics
NPI:1932459393
Name:HEROES HEALTH CARE INC
Entity Type:Organization
Organization Name:HEROES HEALTH CARE INC
Other - Org Name:THE CHICAGO FIX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARGON
Authorized Official - Middle Name:BENJAMIN
Authorized Official - Last Name:ODISHO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:773-805-9517
Mailing Address - Street 1:3139 W 111TH STREET
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60655-2205
Mailing Address - Country:US
Mailing Address - Phone:312-944-4653
Mailing Address - Fax:312-944-0747
Practice Address - Street 1:3139 W 111TH STREET
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60655-2205
Practice Address - Country:US
Practice Address - Phone:312-944-4653
Practice Address - Fax:312-944-0747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-13
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
111N00000X, 207R00000X
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty