Provider Demographics
NPI:1336441849
Name:TRICHARDT CHIROPRACTIC WELLNESS
Entity Type:Organization
Organization Name:TRICHARDT CHIROPRACTIC WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:TRICHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-460-6733
Mailing Address - Street 1:1749 S. NAPERVILLE RD
Mailing Address - Street 2:#207
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189
Mailing Address - Country:US
Mailing Address - Phone:630-460-6733
Mailing Address - Fax:630-752-1222
Practice Address - Street 1:1749 S. NAPERVILLE RD
Practice Address - Street 2:#207
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60189
Practice Address - Country:US
Practice Address - Phone:630-460-6733
Practice Address - Fax:630-752-1222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-03
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty