Provider Demographics
NPI:1457752610
Name:NEW MILLENNIUM MEDICAL, LTD.
Entity Type:Organization
Organization Name:NEW MILLENNIUM MEDICAL, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:PARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:779-552-8358
Mailing Address - Street 1:1424 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:BELVIDERE
Mailing Address - State:IL
Mailing Address - Zip Code:61008-2004
Mailing Address - Country:US
Mailing Address - Phone:779-552-8358
Mailing Address - Fax:779-552-8359
Practice Address - Street 1:1424 N STATE ST
Practice Address - Street 2:
Practice Address - City:BELVIDERE
Practice Address - State:IL
Practice Address - Zip Code:61008-2004
Practice Address - Country:US
Practice Address - Phone:779-552-8358
Practice Address - Fax:779-552-8359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-08
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400191489Medicare PIN
ILF400135972Medicare PIN
ILF100191425Medicare PIN
ILF400135971Medicare PIN