Healthcare Provider Details

I. General information

NPI: 1083820559
Provider Name (Legal Business Name): CHICAGO NECK & BACK INSTITUTE LTD. PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5636 W FULLERTON AVE STE B
CHICAGO IL
60639-2352
US

IV. Provider business mailing address

5636 W FULLERTON AVE STE B
CHICAGO IL
60639-2352
US

V. Phone/Fax

Practice location:
  • Phone: 773-237-8660
  • Fax: 773-237-3159
Mailing address:
  • Phone: 773-237-8660
  • Fax: 773-237-3159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. CATHY G JUNGHEIM
Title or Position: OFFICE MANAGER
Credential:
Phone: 773-237-8660