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General NPI Number Information
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NPI Number | 1568114106
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Entity Type | Organization
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Legal Business Name | GRISIUS CHIROPRACTIC L.L.C.
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Dates
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Enumeration Date | 01/25/2022
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Last Update Date | 01/25/2022
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Provider Practice Location Address
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Address Line | 1642 W BELMONT AVE UNIT 1
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City | CHICAGO
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State | IL
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Zip | 60657-3018
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Country | US
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Telephone | 847-871-3583
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Fax |
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Provider Business Mailing Address
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Address Line | 1101 N CROSBY ST APT A
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City | CHICAGO
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State | IL
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Zip | 60610-2537
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Country | US
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Telephone | 847-871-3583
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR, OWNER
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Name | DR. KYLE GRISIUS
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Credential | DC
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Telephone | 847-871-3583
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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