Provider Demographics
NPI:1972803740
Name:ARLINGTON HEIGHTS CHIROPRACTIC CENTER SC
Entity Type:Organization
Organization Name:ARLINGTON HEIGHTS CHIROPRACTIC CENTER SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:BERKELEY
Authorized Official - Last Name:WENDEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-394-5454
Mailing Address - Street 1:1020 S ARLINGTON HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-3169
Mailing Address - Country:US
Mailing Address - Phone:847-394-5454
Mailing Address - Fax:866-388-7589
Practice Address - Street 1:1020 S ARLINGTON HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-3169
Practice Address - Country:US
Practice Address - Phone:847-394-5454
Practice Address - Fax:866-388-7589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-27
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-007472111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty