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Organization
CHICAGO ANTI AGING INSTITUTE SC
Active
Organization
CHICAGO ANTI AGING INSTITUTE SC
Active
Other names
Chicago Anti Aging Institute
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOREN DAVIS DC (PRESIDENT)
(708) 267-2164
Entity
Organization
Contact information
Practice address
16622 W 159TH ST STE 500, LOCKPORT, IL 60441-8015
(815) 838-7746
(815) 838-5090
Mailing address
16622 W 159TH ST STE 500, LOCKPORT, IL 60441-8015
(815) 838-7746
(815) 838-5090
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
—
NULL
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
—
—
Other
Enumeration date
03/22/2019
Last updated
03/22/2019
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