Provider Demographics
NPI:1194915017
Name:JURIK CHIROPRACTIC & WHOLISTIC HEALTH CARE SC
Entity type:Organization
Organization Name:JURIK CHIROPRACTIC & WHOLISTIC HEALTH CARE SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:JURIK
Authorized Official - Suffix:
Authorized Official - Credentials:DC, RD,LDN
Authorized Official - Phone:630-655-9480
Mailing Address - Street 1:120 E OGDEN AVE
Mailing Address - Street 2:202
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3542
Mailing Address - Country:US
Mailing Address - Phone:630-655-9480
Mailing Address - Fax:630-655-9490
Practice Address - Street 1:120 E OGDEN AVE
Practice Address - Street 2:202
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3542
Practice Address - Country:US
Practice Address - Phone:630-655-9480
Practice Address - Fax:630-655-9490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010439261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILV07696Medicare UPIN
IL212746Medicare PIN