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General NPI Number Information
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NPI Number | 1922575364
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Entity Type | Organization
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Legal Business Name | AVAIL CHIROPRACTIC LLC
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Dates
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Enumeration Date | 10/24/2018
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Last Update Date | 11/20/2018
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Provider Practice Location Address
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Address Line | 10661 S ROBERTS RD STE 103
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City | PALOS HILLS
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State | IL
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Zip | 60465-1992
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Country | US
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Telephone | 708-407-0544
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Fax |
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Provider Business Mailing Address
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Address Line | 10661 S ROBERTS RD STE 103
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City | PALOS HILLS
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State | IL
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Zip | 60465-1992
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Country | US
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Telephone | 708-671-8833
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Fax | 708-671-8847
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | MATEUSZ J CICHOWICZ
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Credential | D.C.
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Telephone | 708-407-0544
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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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