=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104798842
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FIX IT CHIROPRACTIC LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/22/2025
-----------------------------------------------------
Last Update Date | 10/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10518 S ROBERTS RD
-----------------------------------------------------
City | PALOS HILLS
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60465-1934
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 708-974-1150
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1312 GREEN TRAILS DR
-----------------------------------------------------
City | PLAINFIELD
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60586-7616
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 708-974-1150
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEMBER MANAGER
-----------------------------------------------------
Name | DR. VALERIE MOLDOVAN
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 815-409-9149
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------