Healthcare Provider Details

I. General information

NPI: 1134859382
Provider Name (Legal Business Name): CHICAGO PERFORMANCE AND REHAB PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2022
Last Update Date: 06/11/2022
Certification Date: 06/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2324 W IOWA ST APT 2R
CHICAGO IL
60622-4712
US

IV. Provider business mailing address

2324 W IOWA ST APT 2R
CHICAGO IL
60622-4712
US

V. Phone/Fax

Practice location:
  • Phone: 773-573-0895
  • Fax:
Mailing address:
  • Phone: 773-573-0895
  • 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. DANIEL PATRICK DURKIN
Title or Position: CEO
Credential: DC
Phone: 773-573-0895