Basic Information
| Provider Information | |||||||||
| NPI: | 1629311006 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DISCOVER HEALTH CHIROPRACTIC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 534 ROCKHURST RD | ||||||||
| Address2: | |||||||||
| City: | BOLINGBROOK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604402509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6304004140 | ||||||||
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| Practice Location | |||||||||
| Address1: | 534 ROCKHURST RD | ||||||||
| Address2: | |||||||||
| City: | BOLINGBROOK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604402509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6304004140 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2013 | ||||||||
| LastUpdateDate: | 04/03/2013 | ||||||||
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| AuthorizedOfficialLastName: | BAQIR | ||||||||
| AuthorizedOfficialFirstName: | HASSAN | ||||||||
| AuthorizedOfficialMiddleName: | SUHAIL | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6304004140 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | D./C | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 038012309 | IL | Y | 193400000X SINGLE SPECIALTY GROUP | Chiropractic Providers | Chiropractor |
No ID Information.