Provider Demographics
NPI:1700893112
Name:ONDRAS PC
Entity Type:Organization
Organization Name:ONDRAS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:RITTENBACHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-478-3100
Mailing Address - Street 1:11301 DISTINCTIVE DR
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-9460
Mailing Address - Country:US
Mailing Address - Phone:708-478-3100
Mailing Address - Fax:708-478-4382
Practice Address - Street 1:11301 DISTINCTIVE DRIVE
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-9460
Practice Address - Country:US
Practice Address - Phone:708-478-3100
Practice Address - Fax:708-478-4382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
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
IL212552Medicare ID - Type Unspecified
ILU92122Medicare UPIN