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General NPI Number Information
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NPI Number | 1245050194
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Entity Type | Organization
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Legal Business Name | SERENITY FAMILY CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 10/15/2024
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 6321 N AVONDALE AVE STE A108
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City | CHICAGO
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State | IL
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Zip | 60631-1900
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Country | US
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Telephone | 224-587-0129
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Fax |
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Provider Business Mailing Address
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Address Line | 6321 N AVONDALE AVE STE A108
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City | CHICAGO
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State | IL
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Zip | 60631-1900
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Country | US
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Telephone | 224-587-0129
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | ERICA JURIS
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Credential | DC
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Telephone | 224-587-0129
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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