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General NPI Number Information
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NPI Number | 1316178536
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Entity Type | Organization
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Legal Business Name | SKOKIE CHIROPRACTIC & SPORTS INJURY CENTER
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Dates
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Enumeration Date | 08/05/2009
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Last Update Date | 08/05/2009
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Provider Practice Location Address
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Address Line | 8424 SKOKIE BLVD STE. 207
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City | SKOKIE
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State | IL
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Zip | 60077-2568
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Country | US
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Telephone | 847-677-9355
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Fax |
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Provider Business Mailing Address
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Address Line | 8424 SKOKIE BLVD STE. 207
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City | SKOKIE
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State | IL
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Zip | 60077-2568
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Country | US
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Telephone | 847-677-9355
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Fax |
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | DR. JOSH HOVER
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Credential | DC
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Telephone | 847-677-9355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 038-011357
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License Number State | IL
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