Provider Demographics
NPI:1942224506
Name:CHIRO4HEALTH, PC
Entity Type:Organization
Organization Name:CHIRO4HEALTH, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:MIKHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-239-0888
Mailing Address - Street 1:PO BOX 412
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60065-0412
Mailing Address - Country:US
Mailing Address - Phone:847-239-0888
Mailing Address - Fax:
Practice Address - Street 1:300 W ADAMS ST
Practice Address - Street 2:SUITE 515
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606-5101
Practice Address - Country:US
Practice Address - Phone:847-239-0888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-008242111N00000X
WI3923-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1635332OtherBCBS PROVIDER #