Healthcare Provider Details

I. General information

NPI: 1295804730
Provider Name (Legal Business Name): IMMEDIATE HEALTHCARE, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7107 W BELMONT AVE SUITE 8
CHICAGO IL
60634-4688
US

IV. Provider business mailing address

7107 W BELMONT AVE SUITE 8
CHICAGO IL
60634-4688
US

V. Phone/Fax

Practice location:
  • Phone: 773-237-4545
  • Fax: 773-237-9720
Mailing address:
  • Phone: 773-237-4545
  • Fax: 773-237-9720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. ROBERT V. OLSE
Title or Position: OWNER
Credential: D.C
Phone: 773-237-4545