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General NPI Number Information
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NPI Number | 1568097442
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Entity Type | Organization
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Legal Business Name | TLC CHIROPRACTIC, SC
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Dates
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Enumeration Date | 03/11/2020
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Last Update Date | 03/11/2020
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Provider Practice Location Address
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Address Line | 14 MILLER RD
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City | LAKE IN THE HILLS
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State | IL
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Zip | 60156-1008
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Country | US
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Telephone | 224-678-7334
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Fax | 224-678-7307
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Provider Business Mailing Address
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Address Line | 14 MILLER RD
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City | LAKE IN THE HILLS
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State | IL
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Zip | 60156-1008
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Country | US
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Telephone | 224-678-7334
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Fax | 224-678-7307
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Authorized Official
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Title or Position | PRESIDENT/CHIROPRACTOR
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Name | JENNIFER PISHOTTA
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Credential | DC
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Telephone | 224-678-7334
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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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