Provider Demographics
NPI:1134859382
Name:CHICAGO PERFORMANCE AND REHAB PLLC
Entity type:Organization
Organization Name:CHICAGO PERFORMANCE AND REHAB PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:DURKIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:773-573-0895
Mailing Address - Street 1:2324 W IOWA ST APT 2R
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-4712
Mailing Address - Country:US
Mailing Address - Phone:773-573-0895
Mailing Address - Fax:
Practice Address - Street 1:2324 W IOWA ST APT 2R
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-4712
Practice Address - Country:US
Practice Address - Phone:773-573-0895
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-11
Last Update Date:2022-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty