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General NPI Number Information
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NPI Number | 1154530947
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Entity Type | Organization
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Legal Business Name | IVERS CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 01/22/2008
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Provider Practice Location Address
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Address Line | 1024 MCHENRY AVE SUITE E
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City | CRYSTAL LAKE
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State | IL
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Zip | 60014-7477
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Country | US
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Telephone | 815-455-1919
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Fax | 815-455-1455
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Provider Business Mailing Address
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Address Line | 1024 MCHENRY AVE SUITE E
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City | CRYSTAL LAKE
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State | IL
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Zip | 60014-7477
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Country | US
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Telephone | 815-455-1919
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Fax | 815-455-1455
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. CHRISTOPHER IVERS
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Credential | D.C.
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Telephone | 815-455-1919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038006274
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License Number State | IL
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