Provider Demographics
NPI:1336432053
Name:INERTIA HEALTH CENTER, S.C.
Entity Type:Organization
Organization Name:INERTIA HEALTH CENTER, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:S
Authorized Official - Last Name:GOERSCHLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-496-7175
Mailing Address - Street 1:1821 HICKS RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:ROLLING MEADOWS
Mailing Address - State:IL
Mailing Address - Zip Code:60008-1274
Mailing Address - Country:US
Mailing Address - Phone:847-496-7175
Mailing Address - Fax:
Practice Address - Street 1:1821 HICKS RD
Practice Address - Street 2:SUITE B
Practice Address - City:ROLLING MEADOWS
Practice Address - State:IL
Practice Address - Zip Code:60008-1274
Practice Address - Country:US
Practice Address - Phone:847-496-7175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-27
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011935111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty