MEDICARE: CHIROSTRETCH1 INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1770460297
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIROSTRETCH1 INC

Provider Business Mailing Address
First Line	:	47 E CHICAGO AVE STE 332B
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60540-5360
Country	:	US
Telephone Number	:	312-763-6542
Fax Number	:

Provider Business Practice Location Address
First Line	:	47 E CHICAGO AVE STE 332B
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60540-5360
Country	:	US
Telephone Number	:	312-763-6542
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CHIROPRACTOR
Name	:	JERIES JREISAT
Credential	:	DC
Telephone Number	:	312-763-6542

Provider Enumeration Date	:	08/18/2025
Last Update Date	:	08/18/2025

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Directions to “CHIROSTRETCH1 INC ” Practice Location

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