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General NPI Number Information
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NPI Number | 1386432177
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Entity Type | Organization
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Legal Business Name | MOLLY SANDEEP LLC
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Dates
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Enumeration Date | 04/30/2025
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 4806 N HAMILTON AVE
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City | CHICAGO
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State | IL
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Zip | 60625-1406
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Country | US
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Telephone | 872-242-8306
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Fax |
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Provider Business Mailing Address
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Address Line | 2078 N MILWAUKEE AVE # 2
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City | CHICAGO
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State | IL
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Zip | 60647-4002
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Country | US
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Telephone | 440-231-0836
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Fax |
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | MOLLY SANDEEP
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Credential | DC
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Telephone | 440-231-0836
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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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