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General NPI Number Information
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NPI Number | 1528405545
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Entity Type | Organization
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Legal Business Name | NORTH SHORE SPINE & WELLNESS INC
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Dates
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Enumeration Date | 05/30/2013
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Last Update Date | 08/20/2014
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Provider Practice Location Address
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Address Line | 5833 DEMPSTER ST
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City | MORTON GROVE
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State | IL
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Zip | 60053-3028
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Country | US
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Telephone | 847-966-1955
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Fax |
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Provider Business Mailing Address
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Address Line | 5833 DEMPSTER ST
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City | MORTON GROVE
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State | IL
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Zip | 60053-3028
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Country | US
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Telephone | 847-966-1955
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTIC PHYSICIAN
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Name | DR. ADI SWEILEM
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Credential | D.C.
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Telephone | 847-966-1955
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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 | 038012411
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License Number State | IL
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