Provider Demographics
NPI:1962658328
Name:PHYSICIANS FOR NATURAL HEALING AND REHABILITATION
Entity Type:Organization
Organization Name:PHYSICIANS FOR NATURAL HEALING AND REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:J
Authorized Official - Last Name:SANDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:708-785-3496
Mailing Address - Street 1:711 ELM ST
Mailing Address - Street 2:
Mailing Address - City:PROSPECT HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60070-1201
Mailing Address - Country:US
Mailing Address - Phone:708-785-3496
Mailing Address - Fax:
Practice Address - Street 1:711 ELM ST
Practice Address - Street 2:
Practice Address - City:PROSPECT HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60070-1201
Practice Address - Country:US
Practice Address - Phone:708-785-3496
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-16
Last Update Date:2008-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010083111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty