Healthcare Provider Details

I. General information

NPI: 1215385075
Provider Name (Legal Business Name): GOODDAY CHIROPRACTIC&REHAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2016
Last Update Date: 06/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 N PLUM GROVE RD STE A
SCHAUMBURG IL
60173-4807
US

IV. Provider business mailing address

925 N PLUM GROVE RD STE A
SCHAUMBURG IL
60173-4807
US

V. Phone/Fax

Practice location:
  • Phone: 630-912-2574
  • Fax: 630-912-2575
Mailing address:
  • Phone: 630-912-2574
  • Fax: 630-912-2575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number038012005
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: HYUNG SOO KIM
Title or Position: DOCTOR
Credential: DC
Phone: 630-912-2574