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General NPI Number Information
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NPI Number | 1427307099
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Entity Type | Organization
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Legal Business Name | GORDON FIMREITE, DC, S.C.
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Dates
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Enumeration Date | 08/29/2012
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Last Update Date | 08/29/2012
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Provider Practice Location Address
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Address Line | 47 6TH AVE STE L
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City | LA GRANGE
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State | IL
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Zip | 60525-5636
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Country | US
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Telephone | 708-352-3352
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Fax |
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Provider Business Mailing Address
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Address Line | 47 6TH AVE STE L
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City | LA GRANGE
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State | IL
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Zip | 60525-5636
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Country | US
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Telephone | 708-352-3352
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Fax |
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Authorized Official
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Title or Position | PRES
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Name | DR. GORDON K. FIMREITE
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Credential | D.C.
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Telephone | 708-352-3352
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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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