Healthcare Provider Details
I. General information
NPI: 1164458642
Provider Name (Legal Business Name): MILRUD CHIROPRACTIC NATURAL CARE & REHAB, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/25/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1829 S CEDAR LAKE RD
ROUND LAKE IL
60073-5711
US
IV. Provider business mailing address
1829 S CEDAR LAKE RD
ROUND LAKE IL
60073-5711
US
V. Phone/Fax
- Phone: 847-740-9200
- Fax: 847-740-9215
- Phone: 847-740-9200
- Fax: 847-740-9215
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | IL |
VIII. Authorized Official
Name: DR.
LINA
MILRUD
Title or Position: PRESIDENT
Credential: D.C.
Phone: 847-740-9200