Healthcare Provider Details

I. General information

NPI: 1467761858
Provider Name (Legal Business Name): HANS CHIROPRACTIC LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2010
Last Update Date: 12/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 FLETCHER DR STE 304
ELGIN IL
60123-4756
US

IV. Provider business mailing address

1286 ROBERTA CT
GLENDALE HTS IL
60139-3657
US

V. Phone/Fax

Practice location:
  • Phone: 847-888-3131
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038011772
License Number StateIL

VIII. Authorized Official

Name: RYAN MANHYUCK HAN
Title or Position: CHIROPRACTIC
Credential: D.C
Phone: 630-550-9591