Healthcare Provider Details
I. General information
NPI: 1922015023
Provider Name (Legal Business Name): ALTERNATIVE CARE ASSOCIATES S.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/02/2006
Last Update Date: 05/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7775 S HARLEM AVE
BRIDGEVIEW IL
60455-1318
US
IV. Provider business mailing address
7775 S HARLEM AVE
BRIDGEVIEW IL
60455-1318
US
V. Phone/Fax
- Phone: 708-598-2088
- Fax: 708-598-2248
- Phone: 708-598-2088
- Fax: 708-598-2248
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 038003549 |
| License Number State | IL |
VIII. Authorized Official
Name:
BRUCE
V
MILKINT
Title or Position: OWNER
Credential: DC
Phone: 708-598-2088