Provider Demographics
NPI:1932267069
Name:SIKORSKY CHIROPRACTIC CLINIC SC
Entity Type:Organization
Organization Name:SIKORSKY CHIROPRACTIC CLINIC SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:SIKORSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-695-0464
Mailing Address - Street 1:1425 N MCLEAN BLVD
Mailing Address - Street 2:SUITE 700
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-5723
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:104 TYLER CREEK PLZ
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-1784
Practice Address - Country:US
Practice Address - Phone:847-695-0464
Practice Address - Fax:847-695-0461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL212903Medicare ID - Type Unspecified
ILU83195Medicare UPIN