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General NPI Number Information
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NPI Number | 1568760759
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Entity Type | Organization
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Legal Business Name | GRAUN CHIROPRACTIC CLINIC
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Dates
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Enumeration Date | 03/11/2011
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Last Update Date | 03/11/2011
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Provider Practice Location Address
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Address Line | 6428 S CASS AVE
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City | WESTMONT
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State | IL
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Zip | 60559-3209
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Country | US
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Telephone | 630-969-4240
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Fax | 630-920-5029
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Provider Business Mailing Address
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Address Line | 6428 S CASS AVE
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City | WESTMONT
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State | IL
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Zip | 60559-3209
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Country | US
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Telephone | 630-969-4240
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Fax | 630-920-5029
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALVIN C GRAUN
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Credential | D.C.
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Telephone | 630-969-4240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NI0900X
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Taxonomy Name | Internist Chiropractor
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License Number | 038003884
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License Number State | IL
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