Healthcare Provider Details

I. General information

NPI: 1083801187
Provider Name (Legal Business Name): CHIROFIT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2007
Last Update Date: 04/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 N NORTHWEST HWY SUITE 105
BARRINGTON IL
60010-3396
US

IV. Provider business mailing address

303 N NORTHWEST HWY SUITE 105
BARRINGTON IL
60010-3396
US

V. Phone/Fax

Practice location:
  • Phone: 847-382-3194
  • Fax:
Mailing address:
  • Phone: 847-382-3194
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NIKKI MIGLORE
Title or Position: OWNER
Credential:
Phone: 847-382-3194