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General NPI Number Information
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NPI Number | 1578758298
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Entity Type | Organization
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Legal Business Name | NORTH SHORE HEALTH SOLUTIONS LTD
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Dates
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Enumeration Date | 09/06/2007
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Last Update Date | 03/07/2012
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Provider Practice Location Address
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Address Line | 1446 TECHNY RD
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City | NORTHBROOK
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State | IL
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Zip | 60062-5447
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Country | US
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Telephone | 847-715-9060
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Fax | 847-715-9460
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Provider Business Mailing Address
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Address Line | 1446 TECHNY RD
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City | NORTHBROOK
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State | IL
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Zip | 60062-5447
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Country | US
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Telephone | 847-715-9060
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Fax | 847-715-9460
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. KIM JACOBS MARTIN
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Credential | DC
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Telephone | 847-715-9060
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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 | 038.011644
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License Number State | IL
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