Healthcare Provider Details

I. General information

NPI: 1841595030
Provider Name (Legal Business Name): CHIROPRACTIC COMPANY - SHOREWOOD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2011
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3510 N OAKLAND AVE STE. 201
SHOREWOOD WI
53211-2746
US

IV. Provider business mailing address

3510 N OAKLAND AVE STE. 201
SHOREWOOD WI
53211-2746
US

V. Phone/Fax

Practice location:
  • Phone: 414-962-0700
  • Fax: 414-271-1727
Mailing address:
  • Phone: 414-962-0700
  • Fax: 414-271-1727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: JOHN P CORSI
Title or Position: CFO
Credential: DC
Phone: 414-354-5377