Healthcare Provider Details

I. General information

NPI: 1831664036
Provider Name (Legal Business Name): HOVER CHIROPRACTIC AND SPORTS MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2018
Last Update Date: 10/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 W SAINT CHARLES RD
VILLA PARK IL
60181-2424
US

IV. Provider business mailing address

82 W SAINT CHARLES RD
VILLA PARK IL
60181-2424
US

V. Phone/Fax

Practice location:
  • Phone: 630-832-4476
  • Fax:
Mailing address:
  • Phone: 630-832-4476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. VALERIE HOVER
Title or Position: OWNER
Credential: DC
Phone: 630-675-8515