Healthcare Provider Details

I. General information

NPI: 1730877754
Provider Name (Legal Business Name): CENTER FOR INTEGRATED HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2023
Last Update Date: 03/25/2024
Certification Date: 03/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3633 W LAKE AVE STE 105
GLENVIEW IL
60026-5801
US

IV. Provider business mailing address

3633 W LAKE AVE STE 105
GLENVIEW IL
60026-5801
US

V. Phone/Fax

Practice location:
  • Phone: 847-470-1177
  • Fax: 847-470-0368
Mailing address:
  • Phone: 847-470-1177
  • Fax: 847-470-0368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. SPYROS BAKIS
Title or Position: MANAGING MEMBER
Credential: DC
Phone: 847-470-1177