Healthcare Provider Details

I. General information

NPI: 1508317793
Provider Name (Legal Business Name): NATURAL TOUCH CHIROPRACTIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2016
Last Update Date: 10/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4361 N LINCOLN AVE
CHICAGO IL
60618-1741
US

IV. Provider business mailing address

4361 N LINCOLN AVE
CHICAGO IL
60618-1741
US

V. Phone/Fax

Practice location:
  • Phone: 312-610-9757
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038010963
License Number StateIL

VIII. Authorized Official

Name: IRENE MA
Title or Position: OWNER
Credential:
Phone: 312-610-9757