Healthcare Provider Details
I. General information
NPI: 1457698979
Provider Name (Legal Business Name): BUCHAR FAMILY CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/04/2013
Last Update Date: 01/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3015 E NEW YORK ST STE A11
AURORA IL
60504-5163
US
IV. Provider business mailing address
3015 E NEW YORK ST STE A11
AURORA IL
60504-5163
US
V. Phone/Fax
- Phone: 630-820-1330
- Fax:
- Phone: 630-820-1330
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 038010172 |
| License Number State | IL |
VIII. Authorized Official
Name: DR.
SONIA
L
ZEISBERGER
Title or Position: CEO
Credential:
Phone: 630-820-1330