Healthcare Provider Details

I. General information

NPI: 1407119092
Provider Name (Legal Business Name): TOTAL HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2012
Last Update Date: 06/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5101 WASHINGTON ST STE 13
GURNEE IL
60031-2988
US

IV. Provider business mailing address

28010 238TH ST
LE CLAIRE IA
52753-9126
US

V. Phone/Fax

Practice location:
  • Phone: 847-996-0007
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. BRIAN GLAUS
Title or Position: PRESIDENT
Credential:
Phone: 563-289-3076