Provider Demographics
NPI:1699953745
Name:CHIROPRACTIC WORKS OF ILLINOIS, LTD.
Entity type:Organization
Organization Name:CHIROPRACTIC WORKS OF ILLINOIS, LTD.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-984-6460
Mailing Address - Street 1:300 CENTER DR
Mailing Address - Street 2:SUITE 109
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1525
Mailing Address - Country:US
Mailing Address - Phone:847-984-6460
Mailing Address - Fax:847-984-6462
Practice Address - Street 1:300 CENTER DR
Practice Address - Street 2:SUITE 109
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1525
Practice Address - Country:US
Practice Address - Phone:847-984-6460
Practice Address - Fax:847-984-6462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-31
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010144111NI0900X
111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty