Provider Demographics
NPI:1740714450
Name:ELITE RECOVERY CHIROPRACTIC INC
Entity type:Organization
Organization Name:ELITE RECOVERY CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRADY
Authorized Official - Middle Name:DREW
Authorized Official - Last Name:MCDANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:331-215-4919
Mailing Address - Street 1:519 W 87TH ST
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-3128
Mailing Address - Country:US
Mailing Address - Phone:331-215-4919
Mailing Address - Fax:331-215-4917
Practice Address - Street 1:519 W 87TH ST
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60565-3128
Practice Address - Country:US
Practice Address - Phone:331-215-4919
Practice Address - Fax:331-215-4917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-19
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011876111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty