Provider Demographics
NPI:1962672212
Name:ABUNDANT HEALTH CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:ABUNDANT HEALTH CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:MEADE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-590-5670
Mailing Address - Street 1:6300 KINGERY HWY
Mailing Address - Street 2:SUITE 212
Mailing Address - City:WILLOWBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527-2248
Mailing Address - Country:US
Mailing Address - Phone:630-590-5670
Mailing Address - Fax:630-590-5951
Practice Address - Street 1:6300 KINGERY HWY
Practice Address - Street 2:SUITE 212
Practice Address - City:WILLOWBROOK
Practice Address - State:IL
Practice Address - Zip Code:60527-2248
Practice Address - Country:US
Practice Address - Phone:630-590-5670
Practice Address - Fax:630-590-5951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0009932423OtherBCBS IL
IL0009932423OtherBCBS IL