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General NPI Number Information
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NPI Number | 1902096068
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Entity Type | Organization
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Legal Business Name | STILES CHIROPRACTIC OFFICES
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 07/25/2007
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Provider Practice Location Address
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Address Line | 48 E CHICAGO AVE
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City | CHICAGO
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State | IL
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Zip | 60611-2026
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Country | US
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Telephone | 312-642-1138
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Fax | 312-642-1349
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Provider Business Mailing Address
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Address Line | 48 E CHICAGO AVE
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City | CHICAGO
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State | IL
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Zip | 60611-2026
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Country | US
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Telephone | 312-642-1138
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Fax | 312-642-1349
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Authorized Official
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Title or Position | OWNER
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Name | DR. TRACEY D. STILES
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Credential | D.C.
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Telephone | 312-642-1138
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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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