Healthcare Provider Details

I. General information

NPI: 1740298140
Provider Name (Legal Business Name): RR MEDICAL MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5908 S ARCHER AVE
CHICAGO IL
60638-2803
US

IV. Provider business mailing address

5908 S ARCHER AVE
CAROL STREAM IL
60122-0001
US

V. Phone/Fax

Practice location:
  • Phone: 773-767-3822
  • Fax: 773-767-3944
Mailing address:
  • Phone: 773-767-3822
  • Fax: 776-767-3944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: RANDY HARA
Title or Position: OWNER
Credential: DC
Phone: 773-735-0665