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General NPI Number Information
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NPI Number | 1801347521
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Entity Type | Organization
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Legal Business Name | AYZENSHTEYN CHIROPRACTIC S.C
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Dates
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Enumeration Date | 10/18/2016
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Last Update Date | 10/18/2016
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Provider Practice Location Address
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Address Line | 575 LINCOLN AVE
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City | WINNETKA
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State | IL
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Zip | 60093-2307
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Country | US
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Telephone | 847-254-4970
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Fax |
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Provider Business Mailing Address
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Address Line | 575 LINCOLN AVE
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City | WINNETKA
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State | IL
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Zip | 60093-2307
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Country | US
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Telephone | 847-254-4970
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALEX AYZENSHTEYN
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Credential | D.C
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Telephone | 847-254-4970
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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 | 038011825
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License Number State | IL
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