Provider Demographics
NPI:1750384509
Name:BORRE CHIROPRACTIC, LTD.
Entity type:Organization
Organization Name:BORRE CHIROPRACTIC, LTD.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:BORRE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-393-2828
Mailing Address - Street 1:2S610 STATE ROUTE 59
Mailing Address - Street 2:UNIT 9
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-1459
Mailing Address - Country:US
Mailing Address - Phone:630-393-2828
Mailing Address - Fax:630-393-0292
Practice Address - Street 1:2S610 STATE ROUTE 59
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-1459
Practice Address - Country:US
Practice Address - Phone:630-393-2828
Practice Address - Fax:630-393-0292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL7282480OtherDR BORRE ID-AETNA
IL02232251OtherBLUE CROSS BLUE SHIELD
IL6937OtherUNITED HEALTH SERVICE
IL996513OtherGALAXY
IL661636OtherAMERICAN CHIROPRACTIC NET
IL661636OtherUNITED HEALTH CARE
IL7466464OtherCLINIC ID-AETNA
IL2122346216301OtherBEECH STREET
IL02232251OtherBLUE CROSS BLUE SHIELD
IL6937OtherUNITED HEALTH SERVICE
IL204729Medicare ID - Type Unspecified