Healthcare Provider Details

I. General information

NPI: 1639354590
Provider Name (Legal Business Name): RAND CHIROPRACTIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2008
Last Update Date: 04/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 N. RAND ROAD
PALATINE IL
60074-2573
US

IV. Provider business mailing address

2001 N RAND ROAD
PALATINE IL
60074-2573
US

V. Phone/Fax

Practice location:
  • Phone: 847-359-7600
  • Fax: 847-359-7630
Mailing address:
  • Phone: 847-359-7600
  • Fax: 847-359-7630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number038004314
License Number StateIL

VIII. Authorized Official

Name: DR. SUSAN K GREEN
Title or Position: OWNER
Credential: D.C.
Phone: 847-359-7600