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NPI Code Detail

MEDICARE: PREMIER HEALTH CARE, S.C.

MEDICARE: PREMIER HEALTH CARE, S.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorIL

General Provider Information

NPI Number : 1861446429
Entity Type Code : Organization
Provider Name (Legal Business Name) : PREMIER HEALTH CARE, S.C.
Provider Business Mailing Address
First Line : 352 W WOODSTOCK ST
Second Line :
City : CRYSTAL LAKE
State : IL
Zip : 60014-4232
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1400 W NORTHWEST HWY
Second Line :
City : PALATINE
State : IL
Zip : 60067-1837
Country : US
Telephone Number : 815-356-7142
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : ANDREW CARR
Credential :
Telephone Number : 815-356-7142
Provider Enumeration Date : 05/19/2006
Last Update Date : 08/22/2020

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