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General NPI Number Information
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NPI Number | 1871911198
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Entity Type | Organization
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Legal Business Name | INTEL MED
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Dates
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Enumeration Date | 04/03/2014
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Last Update Date | 04/03/2014
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Provider Practice Location Address
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Address Line | 40W131 CAMPTON CROSSINGS DR
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City | CAMPTON HILLS
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State | IL
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Zip | 60175-6570
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Country | US
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Telephone | 630-538-5690
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Fax |
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Provider Business Mailing Address
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Address Line | 7477 WILD OATS TRL
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City | CHERRY VALLEY
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State | IL
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Zip | 61016-9206
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Country | US
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Telephone | 630-538-5690
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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. PHILLIP RINALDO
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Credential | D.C.
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Telephone | 630-538-5690
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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 | 038009259
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License Number State | IL
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