Provider Demographics
NPI:1386924652
Name:THEDR.COM
Entity type:Organization
Organization Name:THEDR.COM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF SCIENCE OFFICER, PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:O'BRYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC, CCN, DACBN
Authorized Official - Phone:877-458-8361
Mailing Address - Street 1:6749 N LAKEWOOD AVE
Mailing Address - Street 2:SUITE 3-N
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-4335
Mailing Address - Country:US
Mailing Address - Phone:877-458-8361
Mailing Address - Fax:877-458-7656
Practice Address - Street 1:6749 N LAKEWOOD AVE
Practice Address - Street 2:SUITE 3-N
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60626-4335
Practice Address - Country:US
Practice Address - Phone:877-458-8361
Practice Address - Fax:877-458-7656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-18
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111NN1001X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Multi-Specialty