Healthcare Provider Details

I. General information

NPI: 1386677557
Provider Name (Legal Business Name): JOYCE FAMILY CHIROPRACTIC INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 05/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3440 W 111TH ST
CHICAGO IL
60655-3302
US

IV. Provider business mailing address

3440 W 111TH ST
CHICAGO IL
60655-3302
US

V. Phone/Fax

Practice location:
  • Phone: 773-429-8912
  • Fax: 773-429-9850
Mailing address:
  • Phone: 773-429-8912
  • Fax: 773-429-9850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038-010196
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070011492
License Number StateIL

VIII. Authorized Official

Name: JOHN JOSEPH JOYCE
Title or Position: PRESIDENT
Credential: D.C.
Phone: 773-429-8912