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General NPI Number Information
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NPI Number | 1588811772
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Entity Type | Organization
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Legal Business Name | CHIROLOGIC SC
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Dates
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Enumeration Date | 08/19/2008
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Last Update Date | 05/20/2010
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Provider Practice Location Address
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Address Line | 540 ALLENDALE DR SUITE 2-E
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City | WHEELING
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State | IL
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Zip | 60090-2603
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Country | US
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Telephone | 847-913-7844
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Fax | 847-897-5990
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Provider Business Mailing Address
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Address Line | 540 ALLENDALE DR SUITE 2-E
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City | WHEELING
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State | IL
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Zip | 60090-2603
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Country | US
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Telephone | 847-913-7844
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Fax | 847-897-5990
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Authorized Official
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Title or Position | CHIROPRACTIC PHYSICIAN
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Name | DR. ALEXANDER GINZBURG
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Credential | DC
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Telephone | 847-913-7844
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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 | 38010137
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License Number State | IL
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