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Organization
PARK RIDGE CHIROPRACTIC
Active
Organization
PARK RIDGE CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIDIA BAHENNA (OFFICE MANAGER)
(847) 318-1144
Entity
Organization
Contact information
Practice address
32 MAIN ST, SUITE B, PARK RIDGE, IL 60068
(847) 318-1144
(847) 318-8866
Mailing address
32 MAIN ST, SUITE B, PARK RIDGE, IL 60068
(847) 318-1144
(847) 318-8866
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01636992
BCBS
IL
01
—
215354
MEDICARE
IL
Enumeration date
04/19/2007
Last updated
05/16/2008
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