Provider Demographics
NPI:1306053368
Name:HOLISTIC CHIROPRACTIC ARTS CENTER
Entity type:Organization
Organization Name:HOLISTIC CHIROPRACTIC ARTS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZAKUTANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-894-0033
Mailing Address - Street 1:290 SPRINGFIELD DR
Mailing Address - Street 2:SUITE 260
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-2214
Mailing Address - Country:US
Mailing Address - Phone:630-894-0033
Mailing Address - Fax:630-894-8678
Practice Address - Street 1:290 SPRINGFIELD DR
Practice Address - Street 2:SUITE 260
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2214
Practice Address - Country:US
Practice Address - Phone:630-894-0033
Practice Address - Fax:630-894-8678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL38-008395111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1790821577Medicare UPIN
IL590730Medicare ID - Type Unspecified