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General NPI Number Information
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NPI Number | 1215061874
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Entity Type | Organization
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Legal Business Name | CHIROCORP P.C.
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 10/18/2017
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Provider Practice Location Address
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Address Line | 6315 DEMPSTER ST
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City | MORTON GROVE
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State | IL
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Zip | 60053-2848
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Country | US
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Telephone | 847-967-0101
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Fax | 847-967-6889
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Provider Business Mailing Address
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Address Line | 5833 W. DEMPSTER ST
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City | MORTON GROVE
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State | IL
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Zip | 60053-2604
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Country | US
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Telephone | 847-967-0101
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Fax | 847-967-6889
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Authorized Official
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Title or Position | PRESIDENT
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Name | DANIEL W ORMAN
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Credential | DC
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Telephone | 847-967-0101
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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 | 038-005601
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License Number State | IL
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