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General NPI Number Information
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NPI Number | 1538468582
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Entity Type | Organization
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Legal Business Name | MIELKE CHIROPRACTIC, CORP.
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Dates
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Enumeration Date | 03/16/2011
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Last Update Date | 01/29/2013
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Provider Practice Location Address
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Address Line | 10 MARTIN AVE SUITE 226
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City | NAPERVILLE
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State | IL
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Zip | 60540-6535
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Country | US
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Telephone | 630-649-0473
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Fax |
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Provider Business Mailing Address
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Address Line | 10 MARTIN AVE SUITE 226
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City | NAPERVILLE
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State | IL
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Zip | 60540-6535
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Country | US
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Telephone | 630-649-0473
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Fax |
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Authorized Official
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Title or Position | OWNER/ALL OFFICERS
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Name | DR. JANICE DIANNE KANE
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Credential | D.C.
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Telephone | 630-649-0473
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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 | 038.011887
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License Number State | IL
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