Provider Demographics
NPI:1417082942
Name:MIDWEST CHIROPRACTIC CLINIC, P.C.
Entity type:Organization
Organization Name:MIDWEST CHIROPRACTIC CLINIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:BARIC
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:847-253-2112
Mailing Address - Street 1:825 E RAND RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-4074
Mailing Address - Country:US
Mailing Address - Phone:847-253-2112
Mailing Address - Fax:847-253-9473
Practice Address - Street 1:825 E RAND RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-4074
Practice Address - Country:US
Practice Address - Phone:847-253-2112
Practice Address - Fax:847-253-9473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty