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General NPI Number Information
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NPI Number | 1528156775
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Entity Type | Organization
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Legal Business Name | SOUTHWEST CHIROPRACTIC REHABILITATION CENTER LTD
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 10/30/2007
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Provider Practice Location Address
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Address Line | 10444 S CENTRAL
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City | OAK LAWN
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State | IL
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Zip | 60453
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Country | US
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Telephone | 708-857-2215
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Fax | 708-857-1042
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Provider Business Mailing Address
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Address Line | 10444 S CENTRAL
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City | OAK LAWN
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State | IL
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Zip | 60453
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Country | US
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Telephone | 708-857-2215
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Fax | 708-857-1042
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | DR. JOHN ALBERT KULIG
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Credential | DC
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Telephone | 708-857-2215
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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 | IL
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