Healthcare Provider Details

I. General information

NPI: 1902096068
Provider Name (Legal Business Name): STILES CHIROPRACTIC OFFICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2007
Last Update Date: 07/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 E CHICAGO AVE
CHICAGO IL
60611-2026
US

IV. Provider business mailing address

48 E CHICAGO AVE
CHICAGO IL
60611-2026
US

V. Phone/Fax

Practice location:
  • Phone: 312-642-1138
  • Fax: 312-642-1349
Mailing address:
  • Phone: 312-642-1138
  • Fax: 312-642-1349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. TRACEY D. STILES
Title or Position: OWNER
Credential: D.C.
Phone: 312-642-1138