Provider Demographics
NPI:1356616957
Name:HOLISTIC CHIROPRACTIC AND ACUPUNCTURE, L.L.C.
Entity type:Organization
Organization Name:HOLISTIC CHIROPRACTIC AND ACUPUNCTURE, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-206-5606
Mailing Address - Street 1:930 N YORK RD STE 100
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3595
Mailing Address - Country:US
Mailing Address - Phone:630-654-9300
Mailing Address - Fax:630-608-2855
Practice Address - Street 1:930 N YORK RD STE 100
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3595
Practice Address - Country:US
Practice Address - Phone:630-654-9300
Practice Address - Fax:630-608-2855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-14
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.012015111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty