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Organization
PRO ACTIVE CHIROPRACTIC PC
Active
Organization
PRO ACTIVE CHIROPRACTIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANA GARLAN RIEDERER DC (PRESIDENT)
(708) 351-2011
Entity
Organization
Contact information
Practice address
223 W JACKSON BLVD STE 1016, CHICAGO, IL 60606-6916
(708) 351-2011
Mailing address
800 S CATHERINE AVE, LA GRANGE, IL 60525-2829
(708) 351-2011
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
10/19/2018
Last updated
02/13/2020
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