Provider Demographics
NPI:1215083530
Name:PREFERRED CHIROPRACTIC CARE CENTER P C
Entity type:Organization
Organization Name:PREFERRED CHIROPRACTIC CARE CENTER P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEVAN
Authorized Official - Suffix:III
Authorized Official - Credentials:DC, FIACA, DABCI
Authorized Official - Phone:630-539-5822
Mailing Address - Street 1:PO BOX 6548
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-6548
Mailing Address - Country:US
Mailing Address - Phone:630-539-5822
Mailing Address - Fax:630-539-5824
Practice Address - Street 1:109 1ST ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-1219
Practice Address - Country:US
Practice Address - Phone:630-539-5822
Practice Address - Fax:630-539-5824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-27
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-007306111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL222-0421OtherBLUE CROSS BLUE SHIELD IL
IL1225120876OtherPERSONAL NPI
IL222-0421OtherBLUE CROSS BLUE SHIELD IL