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General NPI Number Information
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NPI Number | 1902018146
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Entity Type | Organization
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Legal Business Name | LOCKE CHIROPRACTIC
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2060 RIDGE ROAD
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City | HOMEWOOD
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State | IL
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Zip | 60430
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Country | US
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Telephone | 708-798-5625
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Fax |
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Provider Business Mailing Address
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Address Line | 2060 RIDGE ROAD
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City | HOMEWOOD
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State | IL
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Zip | 60430
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Country | US
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Telephone | 708-798-5625
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. ALDRIDGE LOCKE
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Credential | DR.
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Telephone | 708-798-5625
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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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