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General NPI Number Information
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NPI Number | 1528483278
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Entity Type | Organization
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Legal Business Name | CORNERSTONE HEALTH COMPANY
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Dates
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Enumeration Date | 03/04/2014
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Last Update Date | 04/15/2021
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Provider Practice Location Address
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Address Line | 1030 DAVIS ST STE 100
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City | EVANSTON
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State | IL
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Zip | 60201-3702
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Country | US
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Telephone | 847-868-9609
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Fax | 847-440-5476
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Provider Business Mailing Address
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Address Line | 1030 DAVIS ST STE 100
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City | EVANSTON
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State | IL
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Zip | 60201-3702
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Country | US
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Telephone | 847-868-9609
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Fax | 847-440-5476
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Authorized Official
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Title or Position | OWNER
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Name | DR. BENJAMIN FERGUS
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Credential |
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Telephone | 847-868-9609
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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 | 038012514
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License Number State | IL
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