Provider Demographics
NPI:1982750527
Name:COLER CHIROPRACTIC CENTER PC
Entity type:Organization
Organization Name:COLER CHIROPRACTIC CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:COLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:773-229-8888
Mailing Address - Street 1:6657 W ARCHER AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-2419
Mailing Address - Country:US
Mailing Address - Phone:773-229-8888
Mailing Address - Fax:
Practice Address - Street 1:6657 W ARCHER AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638-2419
Practice Address - Country:US
Practice Address - Phone:773-229-8888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038006558111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty