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General NPI Number Information
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NPI Number | 1306196639
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Entity Type | Organization
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Legal Business Name | HUMANA CARE PLUS,P.C.
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Dates
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Enumeration Date | 09/13/2012
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Last Update Date | 02/11/2016
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Provider Practice Location Address
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Address Line | 3138 W MONTROSE AVE
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City | CHICAGO
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State | IL
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Zip | 60618-1333
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Country | US
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Telephone | 773-909-8467
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Fax | 773-945-6382
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Provider Business Mailing Address
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Address Line | 3138 W MONTROSE AVE
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City | CHICAGO
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State | IL
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Zip | 60618-1117
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Country | US
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Telephone | 773-909-8467
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Fax | 773-945-6382
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. VICTOR MENA
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Credential | D.N.
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Telephone | 773-909-8467
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172P00000X
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Taxonomy Name | Naprapath
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License Number | 181.000373
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License Number State | IL
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