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General NPI Number Information
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NPI Number | 1801386271
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Entity Type | Organization
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Legal Business Name | CORNERSTONE INTEGRATIVE HEALTH
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Dates
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Enumeration Date | 05/11/2018
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 5002 MAIN ST STE A
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-3660
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Country | US
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Telephone | 630-475-9111
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Fax |
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Provider Business Mailing Address
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Address Line | 219 S MAIN ST APT 35
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City | LOMBARD
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State | IL
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Zip | 60148-2644
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Country | US
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Telephone | 813-507-1102
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. JACOB J. SUH
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Credential | D.C.
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Telephone | 630-475-9111
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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 | IL
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