Provider Demographics
NPI:1720849227
Name:FARRELLY FAMILY LLC
Entity Type:Organization
Organization Name:FARRELLY FAMILY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CONNOR
Authorized Official - Middle Name:
Authorized Official - Last Name:FARRELLY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-506-8804
Mailing Address - Street 1:1311 BUTTERFIELD RD STE 109
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502-8945
Mailing Address - Country:US
Mailing Address - Phone:630-506-8804
Mailing Address - Fax:630-478-9337
Practice Address - Street 1:1311 BUTTERFIELD RD STE 109
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60502-8945
Practice Address - Country:US
Practice Address - Phone:630-506-8804
Practice Address - Fax:630-478-9337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty