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General NPI Number Information
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NPI Number | 1134247984
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Entity Type | Organization
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Legal Business Name | CENTER FOR PHYSICAL HEALTH LTD
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 12/14/2012
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Provider Practice Location Address
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Address Line | 2201 W SCHAUMBURG RD
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City | SCHAUMBURG
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State | IL
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Zip | 60194-3891
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Country | US
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Telephone | 847-301-8585
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Fax | 847-301-8582
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Provider Business Mailing Address
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Address Line | 2201 W SCHAUMBURG RD
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City | SCHAUMBURG
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State | IL
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Zip | 60194-3891
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Country | US
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Telephone | 847-301-8585
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Fax | 847-301-8582
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CLIFFORD L KEARNS
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Credential | D.C.
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Telephone | 847-301-8585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 038006247
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License Number State | IL
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