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General NPI Number Information
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NPI Number | 1588629018
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Entity Type | Organization
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Legal Business Name | BODY SOLUTIONS CHIROPRACTIC & REHABILITATION CTR, LTD.
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Dates
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Enumeration Date | 04/18/2006
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Last Update Date | 01/08/2008
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Provider Practice Location Address
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Address Line | 40W222 LAFOX RD UNIT G-1
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City | ST CHARLES
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State | IL
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Zip | 60175-7625
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Country | US
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Telephone | 630-762-9415
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Fax | 630-762-9416
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Provider Business Mailing Address
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Address Line | 40W222 LAFOX RD UNIT G-1
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City | ST CHARLES
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State | IL
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Zip | 60175-7625
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Country | US
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Telephone | 630-762-9415
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Fax | 630-762-9416
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Authorized Official
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Title or Position | PRESIDENT-OFFICER/TREATING CLNICIAN
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Name | DR. STEVEN PETER TIRABASSO
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Credential | D.C.
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Telephone | 630-762-9415
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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 | IL
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Taxonomy #2
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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 | IL
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