Provider Demographics
NPI:1023131588
Name:CONSOLIDATED CHIROPRACTIC HEALTH ASSOCIATES INCORPORATION
Entity type:Organization
Organization Name:CONSOLIDATED CHIROPRACTIC HEALTH ASSOCIATES INCORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:IRSHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:KASSIM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-483-8920
Mailing Address - Street 1:180 N BARRINGTON RD
Mailing Address - Street 2:
Mailing Address - City:STREAMWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60107-1966
Mailing Address - Country:US
Mailing Address - Phone:630-483-8920
Mailing Address - Fax:630-483-8930
Practice Address - Street 1:180 N BARRINGTON RD
Practice Address - Street 2:
Practice Address - City:STREAMWOOD
Practice Address - State:IL
Practice Address - Zip Code:60107-1966
Practice Address - Country:US
Practice Address - Phone:630-483-8920
Practice Address - Fax:630-483-8930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILU493737Medicare UPIN
IL204504Medicare ID - Type Unspecified
ILU493736Medicare UPIN