Provider Demographics
NPI:1912248741
Name:INTEGRATIVE FAMILY HEALTHCARE
Entity Type:Organization
Organization Name:INTEGRATIVE FAMILY HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:NOE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:779-423-1700
Mailing Address - Street 1:3626 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61108-1916
Mailing Address - Country:US
Mailing Address - Phone:779-423-1700
Mailing Address - Fax:866-596-1027
Practice Address - Street 1:3626 E STATE ST
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61108-1916
Practice Address - Country:US
Practice Address - Phone:779-423-1700
Practice Address - Fax:866-596-1027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-04
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.012245111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty