Provider Demographics
NPI:1245352160
Name:CARE CHIROPRACTIC CENTER P.C.
Entity type:Organization
Organization Name:CARE CHIROPRACTIC CENTER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:PANTANELLA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-885-1131
Mailing Address - Street 1:1555 N. BARRINGTON ROAD
Mailing Address - Street 2:DOCTOR'S BUILDING ONE, SUITE 335
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-1144
Mailing Address - Country:US
Mailing Address - Phone:847-885-1131
Mailing Address - Fax:847-839-0910
Practice Address - Street 1:1555 N. BARRINGTON ROAD
Practice Address - Street 2:DOCTOR'S BUILDING ONE, SUITE 335
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-1144
Practice Address - Country:US
Practice Address - Phone:847-885-1131
Practice Address - Fax:847-839-0910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-005177111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001636402OtherBLUE SHIELD PROVIDER #
IL0001636402OtherBLUE SHIELD PROVIDER #