Healthcare Provider Details

I. General information

NPI: 1194078451
Provider Name (Legal Business Name): BELRICHARD FAMILY CHIROPRACTIC INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2012
Last Update Date: 01/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

395 CARY ALGONQUIN RD STE C
CARY IL
60013-2084
US

IV. Provider business mailing address

395 CARY ALGONQUIN RD STE C
CARY IL
60013-2084
US

V. Phone/Fax

Practice location:
  • Phone: 847-639-0010
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. RANDY BELRICHARD
Title or Position: BOSSMAN
Credential: BS DC
Phone: 847-639-0010