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General NPI Number Information
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NPI Number | 1912748609
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Entity Type | Organization
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Legal Business Name | BEST LIFE CHIROPRACTIC LLC
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Dates
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Enumeration Date | 06/05/2024
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Last Update Date | 06/18/2024
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Provider Practice Location Address
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Address Line | 1045 BURLINGTON AVE STE 2
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City | LISLE
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State | IL
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Zip | 60532-1959
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Country | US
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Telephone | 630-474-5111
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Fax |
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Provider Business Mailing Address
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Address Line | 1045 BURLINGTON AVE STE 2
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City | LISLE
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State | IL
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Zip | 60532-1959
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO/CHIROPRACTOR
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Name | VICTORIA KOENIG
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Credential |
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Telephone | 630-936-7440
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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 |
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