Provider Demographics
NPI:1952687725
Name:CUMBERLAND CHIROPRACTIC, LTD.
Entity Type:Organization
Organization Name:CUMBERLAND CHIROPRACTIC, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:KARBOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:708-452-4444
Mailing Address - Street 1:4701 N CUMBERLAND AVE
Mailing Address - Street 2:SUITE 1-3A
Mailing Address - City:NORRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60706-2905
Mailing Address - Country:US
Mailing Address - Phone:708-452-4444
Mailing Address - Fax:708-452-7090
Practice Address - Street 1:4701 N CUMBERLAND AVE
Practice Address - Street 2:SUITE 1-3A
Practice Address - City:NORRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60706-2905
Practice Address - Country:US
Practice Address - Phone:708-452-4444
Practice Address - Fax:708-452-7090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-25
Last Update Date:2012-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL6749Medicare PIN