Healthcare Provider Details

I. General information

NPI: 1770729741
Provider Name (Legal Business Name): CHIROBIOMECHANICAL, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2008
Last Update Date: 12/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 E GOLF RD
ARLINGTON HEIGHTS IL
60005-4061
US

IV. Provider business mailing address

612 E GOLF RD
ARLINGTON HEIGHTS IL
60005-4061
US

V. Phone/Fax

Practice location:
  • Phone: 847-718-0071
  • Fax: 847-718-0103
Mailing address:
  • Phone: 847-718-0071
  • Fax: 847-718-0103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number038007530
License Number StateIL

VIII. Authorized Official

Name: DR. RYAN HAMM
Title or Position: D.C.
Credential:
Phone: 847-718-0071