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General NPI Number Information
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NPI Number | 1205933116
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Entity Type | Organization
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Legal Business Name | CHIRO-MED PAIN TREATMENT CENTER P.C.
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 08/19/2010
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Provider Practice Location Address
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Address Line | 9441 W 144TH PL
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City | ORLAND PARK
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State | IL
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Zip | 60462-2543
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Country | US
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Telephone | 708-403-2727
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Fax | 708-403-2770
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Provider Business Mailing Address
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Address Line | 9441 W 144TH PL
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City | ORLAND PARK
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State | IL
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Zip | 60462-2543
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Country | US
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Telephone | 708-403-2727
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Fax | 708-403-2770
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ERIC A MILLER
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Credential | DC
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Telephone | 708-403-2727
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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 | 038-006912
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License Number State | IL
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