Provider Demographics
NPI:1396884060
Name:RADIANT HEALTH, INC.
Entity type:Organization
Organization Name:RADIANT HEALTH, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:C
Authorized Official - Last Name:LINN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-428-2228
Mailing Address - Street 1:33 W HIGGINS RD
Mailing Address - Street 2:SUITE 5020
Mailing Address - City:SOUTH BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-9115
Mailing Address - Country:US
Mailing Address - Phone:847-428-2228
Mailing Address - Fax:847-428-1577
Practice Address - Street 1:33 W HIGGINS RD
Practice Address - Street 2:SUITE 5020
Practice Address - City:SOUTH BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-9115
Practice Address - Country:US
Practice Address - Phone:847-428-2228
Practice Address - Fax:847-428-1577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U73879Medicare UPIN
210985Medicare ID - Type Unspecified