Provider Demographics
NPI:1912127762
Name:COMBINEDCARE, P.C.
Entity Type:Organization
Organization Name:COMBINEDCARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:M
Authorized Official - Last Name:FAIRMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-328-1975
Mailing Address - Street 1:8707 SKOKIE BLVD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-2281
Mailing Address - Country:US
Mailing Address - Phone:847-328-1975
Mailing Address - Fax:847-328-1976
Practice Address - Street 1:8707 SKOKIE BLVD
Practice Address - Street 2:SUITE 307
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-2281
Practice Address - Country:US
Practice Address - Phone:847-328-1975
Practice Address - Fax:847-328-1976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-006979111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL970490Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
ILU29282Medicare UPIN