Provider Demographics
NPI:1386724441
Name:CHIROPRACTIC CARE CENTER LTD
Entity type:Organization
Organization Name:CHIROPRACTIC CARE CENTER LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OWNER PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:B
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:815-741-9550
Mailing Address - Street 1:350 HOUBOLT RD
Mailing Address - Street 2:SUITE #101
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60431-8305
Mailing Address - Country:US
Mailing Address - Phone:815-741-9550
Mailing Address - Fax:815-741-9552
Practice Address - Street 1:350 HOUBOLT RD
Practice Address - Street 2:SUITE #101
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60431-8305
Practice Address - Country:US
Practice Address - Phone:815-741-9550
Practice Address - Fax:815-741-9552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2008-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0009982017OtherBCBS