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General NPI Number Information
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NPI Number | 1245485796
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Entity Type | Organization
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Legal Business Name | PINS FAMILY CHIROPRACTIC
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Dates
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Enumeration Date | 11/25/2008
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Last Update Date | 11/25/2008
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Provider Practice Location Address
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Address Line | 1113 S MILWAUKEE AVE
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City | LIBERTYVILLE
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State | IL
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Zip | 60048-3758
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Country | US
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Telephone | 847-689-9500
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Fax |
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Provider Business Mailing Address
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Address Line | 1113 S MILWAUKEE AVE
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City | LIBERTYVILLE
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State | IL
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Zip | 60048-3758
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Country | US
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Telephone | 847-689-9500
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRADLEY W PINS
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Credential | D.C.
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Telephone | 630-527-9100
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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 | 038008344
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License Number State | IL
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