Provider Demographics
NPI:1295804730
Name:IMMEDIATE HEALTHCARE, LTD.
Entity type:Organization
Organization Name:IMMEDIATE HEALTHCARE, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:V
Authorized Official - Last Name:OLSE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:773-237-4545
Mailing Address - Street 1:7107 W BELMONT AVE
Mailing Address - Street 2:SUITE 8
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-4688
Mailing Address - Country:US
Mailing Address - Phone:773-237-4545
Mailing Address - Fax:773-237-9720
Practice Address - Street 1:7107 W BELMONT AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-4688
Practice Address - Country:US
Practice Address - Phone:773-237-4545
Practice Address - Fax:773-237-9720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL574100Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER