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General NPI Number Information
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NPI Number | 1033030564
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Entity Type | Organization
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Legal Business Name | CHICAGO ANTI-AGING INSTITUTION 2, SC
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Dates
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Enumeration Date | 07/22/2026
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Last Update Date | 07/22/2026
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Provider Practice Location Address
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Address Line | 14497 JOHN HUMPHREY DR STE 101
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City | ORLAND PARK
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State | IL
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Zip | 60462-2637
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Country | US
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Telephone | 815-905-3506
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Fax | 815-905-3822
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Provider Business Mailing Address
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Address Line | 14497 JOHN HUMPHREY DR STE 101
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City | ORLAND PARK
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State | IL
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Zip | 60462-2637
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Country | US
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Telephone | 815-905-3506
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Fax | 815-905-3822
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LOREN DAVIS
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Credential | DC
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Telephone | 708-267-2164
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 202D00000X
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Taxonomy Name | Integrative Medicine Physician
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License Number |
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License Number State |
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