Provider Demographics
NPI:1811176746
Name:HARRIS CHIROPRACTIC, INC
Entity type:Organization
Organization Name:HARRIS CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-513-1557
Mailing Address - Street 1:6602 BARRINGTON RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:HANOVER PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60133-3900
Mailing Address - Country:US
Mailing Address - Phone:630-483-7246
Mailing Address - Fax:630-483-7258
Practice Address - Street 1:6602 BARRINGTON RD
Practice Address - Street 2:STE C
Practice Address - City:HANOVER PARK
Practice Address - State:IL
Practice Address - Zip Code:60133-3900
Practice Address - Country:US
Practice Address - Phone:630-483-7246
Practice Address - Fax:630-483-7258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-27
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010908111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
67316Medicare UPIN