Healthcare Provider Details

I. General information

NPI: 1205048329
Provider Name (Legal Business Name): CHIROPRACTIC HEALTH & FITNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 10/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 W DUNDEE RD
WHEELING IL
60090-3936
US

IV. Provider business mailing address

1111 W DUNDEE RD
WHEELING IL
60090-3936
US

V. Phone/Fax

Practice location:
  • Phone: 847-459-0321
  • Fax: 847-459-4246
Mailing address:
  • Phone: 847-459-0321
  • Fax: 847-459-4246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number038003785
License Number StateIL

VIII. Authorized Official

Name: DR. CONSTANCE C. HEIN
Title or Position: OWNER
Credential: D.C.
Phone: 847-459-0321