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General NPI Number Information
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NPI Number | 1376165712
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Entity Type | Organization
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Legal Business Name | PATIE LLC
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Dates
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Enumeration Date | 05/07/2020
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Last Update Date | 09/28/2020
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Provider Practice Location Address
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Address Line | 533 W NORTH AVE
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City | ELMHURST
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State | IL
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Zip | 60126-2910
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Country | US
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Telephone | 630-501-1093
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Fax |
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Provider Business Mailing Address
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Address Line | 533 W NORTH AVE #LL50
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City | ELMHURST
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State | IL
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Zip | 60126
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Country | US
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Telephone | 630-501-1093
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Fax |
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Authorized Official
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Title or Position | CO-OWNER/CO-CEO
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Name | DR. KATIE NIEBUR
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Credential | ND, DC
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Telephone | 708-362-2337
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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