Healthcare Provider Details

I. General information

NPI: 1114105301
Provider Name (Legal Business Name): MEI CHIROPRACTIC, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2008
Last Update Date: 05/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

467 W 31ST ST
CHICAGO IL
60616-3135
US

IV. Provider business mailing address

467 W 31ST ST
CHICAGO IL
60616-3135
US

V. Phone/Fax

Practice location:
  • Phone: 321-225-6434
  • Fax:
Mailing address:
  • Phone: 321-225-6434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number038007401
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number198.000230
License Number StateIL

VIII. Authorized Official

Name: DR. HUBERT MEI
Title or Position: PRESIDENT
Credential: D.C. LAC. DABCO
Phone: 312-225-6434