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General NPI Number Information
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NPI Number | 1306204268
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Entity Type | Organization
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Legal Business Name | ABSOLUTE BODY CARE
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Dates
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Enumeration Date | 02/08/2016
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Last Update Date | 07/19/2016
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Provider Practice Location Address
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Address Line | 8 SOUTH MICHIGAN AVENUE SUITE 2020
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City | CHICAGO
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State | IL
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Zip | 60603-5520
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Country | US
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Telephone | 700-000-0000
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Fax | 773-945-9341
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Provider Business Mailing Address
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Address Line | 5012 N TRIPP AVE
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City | CHICAGO
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State | IL
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Zip | 60630-2725
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Country | US
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Telephone | 700-000-0000
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Fax | 773-945-9341
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Authorized Official
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Title or Position | DOCTOR OF CHIROPACTIC
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Name | DR. MINSOOK D KROON
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Credential | D.C
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Telephone | 700-000-0000
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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 | 038011066
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License Number State | IL
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