Provider Demographics
NPI:1205335650
Name:MMAC HEALTH
Entity type:Organization
Organization Name:MMAC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:TAMRAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:224-585-8154
Mailing Address - Street 1:1694 CARTHAGE CT
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-9254
Mailing Address - Country:US
Mailing Address - Phone:630-290-9938
Mailing Address - Fax:
Practice Address - Street 1:8888 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-1752
Practice Address - Country:US
Practice Address - Phone:224-585-8154
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-12
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty