Provider Demographics
NPI: | 1083801187 |
---|---|
Name: | CHIROFIT, LLC |
Entity type: | Organization |
Organization Name: | CHIROFIT, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | NIKKI |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MIGLORE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 847-382-3194 |
Mailing Address - Street 1: | 303 N NORTHWEST HWY |
Mailing Address - Street 2: | SUITE 105 |
Mailing Address - City: | BARRINGTON |
Mailing Address - State: | IL |
Mailing Address - Zip Code: | 60010-3396 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 847-382-3194 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 303 N NORTHWEST HWY |
Practice Address - Street 2: | SUITE 105 |
Practice Address - City: | BARRINGTON |
Practice Address - State: | IL |
Practice Address - Zip Code: | 60010-3396 |
Practice Address - Country: | US |
Practice Address - Phone: | 847-382-3194 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-10-02 |
Last Update Date: | 2008-04-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 111N00000X | Chiropractic Providers | Chiropractor | Group - Single Specialty | |
No | 261QM2500X | Ambulatory Health Care Facilities | Clinic/Center | Medical Specialty | Group - Single Specialty |