Provider Demographics
NPI:1801449566
Name:NEUROLOGIC AND HEADACHE CLINIC
Entity type:Organization
Organization Name:NEUROLOGIC AND HEADACHE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:ITKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-361-0222
Mailing Address - Street 1:7600 W COLLEGE DR STE 5
Mailing Address - Street 2:
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1035
Mailing Address - Country:US
Mailing Address - Phone:087-485-4663
Mailing Address - Fax:708-671-8387
Practice Address - Street 1:7600 W COLLEGE DR STE 5
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1035
Practice Address - Country:US
Practice Address - Phone:087-485-4663
Practice Address - Fax:708-671-8387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-22
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty