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General NPI Number Information
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NPI Number | 1639985781
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Entity Type | Organization
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Legal Business Name | ACTIVE CARE PHYSICAL MEDICINE
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Dates
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Enumeration Date | 12/04/2024
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 216 E SAINT CHARLES RD
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City | LOMBARD
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State | IL
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Zip | 60148-2331
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Country | US
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Telephone | 630-401-2901
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Fax |
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Provider Business Mailing Address
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Address Line | 1066 APPLE LN
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City | LOMBARD
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State | IL
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Zip | 60148-4030
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Country | US
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Telephone | 630-401-2901
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTIC PHYSICIAN
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Name | DR. KRISTI PAJCINI
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Credential | DC
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Telephone | 630-401-2901
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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 |
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