=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679008239
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NELLI KAPLUNSKAYA DC LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/20/2017
-----------------------------------------------------
Last Update Date | 04/20/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1845 W GOLF RD
-----------------------------------------------------
City | SCHAUMBURG
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60194-1148
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-885-8808
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1845 W GOLF RD
-----------------------------------------------------
City | SCHAUMBURG
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60194-1148
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-885-8808
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DR.
-----------------------------------------------------
Name | NELLI KAPLUNSKAYA
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 847-338-7963
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 038.012990
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------