Healthcare Provider Details

I. General information

NPI: 1326165135
Provider Name (Legal Business Name): AFFILIATED HEALTH CARE ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2229 W CHICAGO AVE
CHICAGO IL
60622-4828
US

IV. Provider business mailing address

2229 W CHICAGO AVE
CHICAGO IL
60622-4828
US

V. Phone/Fax

Practice location:
  • Phone: 773-862-4500
  • Fax: 773-862-4517
Mailing address:
  • Phone: 773-862-4500
  • Fax: 773-862-4517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number StateIL

VIII. Authorized Official

Name: JAROSLAW SLUSARENKO
Title or Position: PRESIDENT
Credential: D.C.
Phone: 773-862-4500