Healthcare Provider Details

I. General information

NPI: 1417082942
Provider Name (Legal Business Name): MIDWEST CHIROPRACTIC CLINIC, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 E RAND RD
ARLINGTON HEIGHTS IL
60004-4074
US

IV. Provider business mailing address

825 E RAND RD
ARLINGTON HEIGHTS IL
60004-4074
US

V. Phone/Fax

Practice location:
  • Phone: 847-253-2112
  • Fax: 847-253-9473
Mailing address:
  • Phone: 847-253-2112
  • Fax: 847-253-9473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number
License Number StateIL

VIII. Authorized Official

Name: JOSEPH J BARIC JR.
Title or Position: PRESIDENT
Credential: D.C.
Phone: 847-253-2112