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General NPI Number Information
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NPI Number | 1548912835
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Entity Type | Organization
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Legal Business Name | PAIN STOP CHIROPRACTIC INC
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Dates
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Enumeration Date | 01/19/2022
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Last Update Date | 04/28/2022
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Provider Practice Location Address
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Address Line | 1324 E OGDEN AVE STE 100
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City | NAPERVILLE
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State | IL
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Zip | 60563-2347
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Country | US
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Telephone | 630-718-1111
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Fax | 630-718-1110
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Provider Business Mailing Address
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Address Line | 370 HOBBLE BUSH DR
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City | LAKE ZURICH
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State | IL
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Zip | 60047-2740
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAESUN MA
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Credential | DC
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Telephone | 224-363-1717
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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 |
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