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NPI 1730886417

NPI 1730886417 : ALECK PAIN TO PERFORMANCE : FRANKFORT, IL

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General NPI Number Information
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    NPI Number           |    1730886417
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    Entity Type          |    Organization 
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    Legal Business Name  |    ALECK PAIN TO PERFORMANCE 
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Dates
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    Enumeration Date     |    02/13/2023
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    Last Update Date     |    02/13/2023
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Provider Practice Location Address
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    Address Line         |    11 S WHITE ST STE 201 
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    City                 |    FRANKFORT
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    State                |    IL
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    Zip                  |    60423-4011
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    Country              |    US
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    Telephone            |    815-277-2921
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    11 S WHITE ST STE 201 
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    City                 |    FRANKFORT
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    State                |    IL
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    Zip                  |    60423-4011
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    Country              |    US
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    Telephone            |    815-277-2921
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     JAKE  ALECK 
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    Credential           |    
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    Telephone            |    815-405-5269
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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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