Provider Demographics
NPI:1134520398
Name:SHIMMEL
Entity type:Organization
Organization Name:SHIMMEL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:AMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:773-255-6475
Mailing Address - Street 1:1 E SUPERIOR ST
Mailing Address - Street 2:SUITE 307
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2507
Mailing Address - Country:US
Mailing Address - Phone:312-664-8376
Mailing Address - Fax:312-664-8417
Practice Address - Street 1:1 E SUPERIOR ST
Practice Address - Street 2:SUITE 307
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2507
Practice Address - Country:US
Practice Address - Phone:312-664-8376
Practice Address - Fax:312-664-8417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038006395111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty