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General NPI Number Information
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NPI Number | 1447311659
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Entity Type | Organization
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Legal Business Name | CHIROPRACTIC ARTS CENTER OF MORTON GROVE, P.C.
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 12/21/2018
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Provider Practice Location Address
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Address Line | 6032 LINCOLN AVE
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City | MORTON GROVE
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State | IL
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Zip | 60053-2955
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Country | US
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Telephone | 847-470-0047
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Fax |
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Provider Business Mailing Address
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Address Line | 6032 LINCOLN AVE
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City | MORTON GROVE
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State | IL
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Zip | 60053-2955
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Country | US
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Telephone | 847-470-0047
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LINDA ANN PINKUS
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Credential | DC
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Telephone | 847-470-0047
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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 | 060-007704
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038-009042
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License Number State | IL
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