Provider Demographics
NPI:1306061916
Name:UPTOWN CHIROPRACTIC CLINIC LTD
Entity type:Organization
Organization Name:UPTOWN CHIROPRACTIC CLINIC LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:M
Authorized Official - Last Name:MORSE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-692-2688
Mailing Address - Street 1:131 S NORTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-4228
Mailing Address - Country:US
Mailing Address - Phone:847-692-2688
Mailing Address - Fax:847-692-2921
Practice Address - Street 1:131 S NORTHWEST HWY
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-4228
Practice Address - Country:US
Practice Address - Phone:847-692-2688
Practice Address - Fax:847-692-2921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL207235Medicare ID - Type Unspecified
ILU46958Medicare UPIN