Provider Demographics
NPI:1962538793
Name:WRIGLEYVILLE CHIROPRACTIC AND MASSAGE LTD.
Entity type:Organization
Organization Name:WRIGLEYVILLE CHIROPRACTIC AND MASSAGE LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:N
Authorized Official - Last Name:ROSENKRANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:773-360-3320
Mailing Address - Street 1:911 W SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-2576
Mailing Address - Country:US
Mailing Address - Phone:773-360-3320
Mailing Address - Fax:773-572-1827
Practice Address - Street 1:911 W SCHOOL ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-2576
Practice Address - Country:US
Practice Address - Phone:773-360-3320
Practice Address - Fax:773-572-8127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-008215111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1635606OtherBCBS
IL7621736OtherAETNA
IL20-3439545OtherHUMANA
IL1635606OtherBCBS