Healthcare Provider Details

I. General information

NPI: 1427363134
Provider Name (Legal Business Name): PLANET CHIRO WEST DUNDEE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2010
Last Update Date: 08/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

758 S 8TH ST
WEST DUNDEE IL
60118-2102
US

IV. Provider business mailing address

3015 E NEW YORK ST STE A11
AURORA IL
60504-5163
US

V. Phone/Fax

Practice location:
  • Phone: 847-836-5202
  • Fax:
Mailing address:
  • Phone: 630-820-1330
  • Fax: 630-820-1554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038-010110
License Number StateIL

VIII. Authorized Official

Name: DR. WILLIAM BUCHAR
Title or Position: CEO
Credential: D.C.
Phone: 630-820-1330