Provider Demographics
NPI:1720533417
Name:CHILLEMI HOLDINGS, LLC
Entity type:Organization
Organization Name:CHILLEMI HOLDINGS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHILLEMI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-759-3050
Mailing Address - Street 1:544 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-3334
Mailing Address - Country:US
Mailing Address - Phone:973-759-3050
Mailing Address - Fax:973-759-2046
Practice Address - Street 1:12 S HOLMDEL RD
Practice Address - Street 2:
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-2130
Practice Address - Country:US
Practice Address - Phone:973-759-3050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-23
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00532100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty