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General NPI Number Information
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NPI Number | 1871895011
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Entity Type | Organization
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Legal Business Name | GLOBAL CHIROPRACTIC CARE LTD
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Dates
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Enumeration Date | 11/19/2010
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Last Update Date | 11/19/2010
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Provider Practice Location Address
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Address Line | 2051 W BELMONT AVE
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City | CHICAGO
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State | IL
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Zip | 60618-6467
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Country | US
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Telephone | 773-525-8100
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Fax | 773-525-8130
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Provider Business Mailing Address
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Address Line | 2051 W BELMONT AVE
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City | CHICAGO
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State | IL
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Zip | 60618-6467
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Country | US
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Telephone | 773-525-8100
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Fax | 773-525-8130
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MEHRAN RAZI SOROURI
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Credential | D.C., C.S.C.S., CCSP
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Telephone | 773-525-8100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 038009498
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License Number State | IL
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