Provider Demographics
NPI:1346358629
Name:ALLGEIER, MICHAEL A JR (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:ALLGEIER
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 W POLK ST
Mailing Address - Street 2:SUITE G-1
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-2000
Mailing Address - Country:US
Mailing Address - Phone:312-519-8412
Mailing Address - Fax:312-922-5860
Practice Address - Street 1:47 W POLK ST
Practice Address - Street 2:SUITE G-1
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-2000
Practice Address - Country:US
Practice Address - Phone:312-922-3011
Practice Address - Fax:312-922-5860
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-010754111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01638618OtherBLUE CROSS BLUE SHIELD OF ILLINOIS
ILK49935Medicare UPIN