Healthcare Provider Details

I. General information

NPI: 1982920815
Provider Name (Legal Business Name): CENTER FOR INTERGRATIVE HEALTH, SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2010
Last Update Date: 04/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1410 WAUKEGAN RD STE 180
GLENVIEW IL
60025-2172
US

IV. Provider business mailing address

1410 WAUKEGAN RD STE 180
GLENVIEW IL
60025-2172
US

V. Phone/Fax

Practice location:
  • Phone: 847-832-9000
  • Fax: 847-998-0394
Mailing address:
  • Phone: 847-832-9000
  • Fax: 847-998-0394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038009615
License Number StateIL

VIII. Authorized Official

Name: DR. ANDREW HAJDUK
Title or Position: PRESIDENT
Credential: DC
Phone: 847-832-9000