=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801691100
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BOWERS CHIROPRACTIC CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/19/2025
-----------------------------------------------------
Last Update Date | 02/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1001 OGDEN AVE STE 101
-----------------------------------------------------
City | DOWNERS GROVE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60515-2871
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-322-9522
-----------------------------------------------------
Fax | 630-322-9515
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1001 OGDEN AVE STE 101
-----------------------------------------------------
City | DOWNERS GROVE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60515-2871
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-322-9522
-----------------------------------------------------
Fax | 630-322-9515
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE/BILLING MANAGER
-----------------------------------------------------
Name | STEPHANIE HUSS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 630-322-9522
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM2500X
-----------------------------------------------------
Taxonomy Name | Medical Specialty Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------