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General NPI Number Information
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NPI Number | 1215124227
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Entity Type | Organization
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Legal Business Name | JKT ENTERPRISES INC.
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Dates
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Enumeration Date | 10/03/2007
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Last Update Date | 08/02/2013
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Provider Practice Location Address
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Address Line | 43 W ACORN LN
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City | LAKE IN THE HILLS
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State | IL
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Zip | 60156-4804
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Country | US
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Telephone | 847-854-5356
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Fax | 847-854-5436
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Provider Business Mailing Address
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Address Line | 43 WEST ACORN LANE
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City | LAKE IN THE HILLS
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State | IL
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Zip | 60156-4804
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Country | US
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Telephone | 847-854-5356
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Fax | 847-854-5436
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | MR. ALOK TRIVEDI
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Credential | D.C.
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Telephone | 847-854-5356
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 038009757
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License Number State | IL
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