Provider Demographics
NPI:1104167261
Name:5-STAR CHIROPRACTIC, LTD.
Entity type:Organization
Organization Name:5-STAR CHIROPRACTIC, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/ PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAT
Authorized Official - Middle Name:
Authorized Official - Last Name:FIORE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:773-631-5555
Mailing Address - Street 1:5057 N HARLEM AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60656-3501
Mailing Address - Country:US
Mailing Address - Phone:773-631-5555
Mailing Address - Fax:773-631-5557
Practice Address - Street 1:5057 N HARLEM AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60656-3501
Practice Address - Country:US
Practice Address - Phone:773-631-5555
Practice Address - Fax:773-631-5557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-007070111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty