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General NPI Number Information
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NPI Number | 1457519670
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Entity Type | Organization
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Legal Business Name | YAMADA CHIROPRACTIC CLINIC, P.C.
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Dates
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Enumeration Date | 05/23/2008
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Last Update Date | 05/23/2008
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Provider Practice Location Address
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Address Line | 116 S PROSPECT ST
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City | ROSELLE
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State | IL
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Zip | 60172-2049
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Country | US
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Telephone | 630-307-1150
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Fax | 630-307-3536
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Provider Business Mailing Address
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Address Line | 116 S PROSPECT ST
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City | ROSELLE
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State | IL
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Zip | 60172-2049
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Country | US
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Telephone | 630-307-1150
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Fax | 630-307-3536
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Authorized Official
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Title or Position | SECRETARY
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Name | MS. YOKO YAMADA
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Credential |
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Telephone | 630-899-9436
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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 | 038010412
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License Number State | IL
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