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General NPI Number Information
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NPI Number | 1932347564
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Entity Type | Organization
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Legal Business Name | ARROW PHYSICIANS GROUP, S.C.
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Dates
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Enumeration Date | 02/04/2009
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Last Update Date | 05/04/2009
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Provider Practice Location Address
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Address Line | 24441 W EAMES ST
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City | CHANNAHON
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State | IL
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Zip | 60410-5177
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Country | US
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Telephone | 815-467-7020
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Fax |
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Provider Business Mailing Address
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Address Line | 24441 W. EAMES ST.
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City | CHANNAHON
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State | IL
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Zip | 60410
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Country | US
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Telephone | 815-467-7020
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Fax | 815-467-7058
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAKE L. WINES
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Credential | D.C.
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Telephone | 815-467-7020
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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 | 038.009588
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License Number State | IL
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