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General NPI Number Information
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NPI Number | 1417832627
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Entity Type | Organization
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Legal Business Name | NORD RO
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Dates
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Enumeration Date | 08/07/2025
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 2908 N LINCOLN AVE
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City | CHICAGO
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State | IL
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Zip | 60657-4109
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Country | US
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Telephone | 773-886-0960
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Fax | 773-234-9932
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Provider Business Mailing Address
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Address Line | 2908 N LINCOLN AVE
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City | CHICAGO
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State | IL
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Zip | 60657-4109
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Country | US
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Telephone | 773-886-0960
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Fax | 773-234-9932
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | SEBASTIAN MICHAEL BERGERON
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Credential | DC
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Telephone | 773-886-0960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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