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General NPI Number Information
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NPI Number | 1235490418
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Entity Type | Organization
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Legal Business Name | SKOKIE CHIRO PLUS INC
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Dates
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Enumeration Date | 06/04/2012
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Last Update Date | 01/04/2016
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Provider Practice Location Address
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Address Line | 9150 CRAWFORD AVE. SUITE 204
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City | SKOKIE
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State | IL
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Zip | 60076
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Country | US
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Telephone | 773-255-2979
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Fax | 847-677-2540
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Provider Business Mailing Address
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Address Line | 9150 CRAWFORD AVE. SUITE 204
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City | SKOKIE
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State | IL
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Zip | 60076-1769
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Country | US
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Telephone | 773-255-2979
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Fax | 847-677-2540
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Authorized Official
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Title or Position | PRESIDENT
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Name | IRWIN L. HELLER
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Credential | D.C.
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Telephone | 773-255-2979
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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 | 038-006160
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License Number State | IL
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