Healthcare Provider Details
I. General information
NPI: 1346924057
Provider Name (Legal Business Name): TRI-CITY HEALTH CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/13/2023
Last Update Date: 06/13/2023
Certification Date: 06/13/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2401 KANEVILLE RD STE 3
GENEVA IL
60134-2577
US
IV. Provider business mailing address
105 DARTMOUTH CT
GENEVA IL
60134-1738
US
V. Phone/Fax
- Phone: 630-715-1183
- Fax:
- Phone: 630-677-9750
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 175F00000X |
| Taxonomy | Naturopath |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
AMANDA
DRISCOLL
Title or Position: OWNER/DOCTOR
Credential: DC, ND
Phone: 630-677-9750