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General NPI Number Information
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NPI Number | 1215751029
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Entity Type | Organization
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Legal Business Name | SPINE IQ, LLC
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Dates
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Enumeration Date | 11/09/2024
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Last Update Date | 11/09/2024
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Provider Practice Location Address
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Address Line | 9501 171ST ST STE I
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City | TINLEY PARK
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State | IL
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Zip | 60487-6111
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Country | US
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Telephone | 708-945-2276
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Fax |
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Provider Business Mailing Address
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Address Line | 16514 OXFORD DR
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City | TINLEY PARK
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State | IL
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Zip | 60477-1744
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Country | US
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Telephone | 708-945-2276
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Fax |
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Authorized Official
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Title or Position | OWNER/CHIROPRACTIC PHYSICIAN
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Name | DR. JAWAD M SALMAN
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Credential | DC
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Telephone | 708-945-2276
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number |
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License Number State |
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