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Organization
RAVENSWOOD HEALTH CENTER, P.C.
Active
Organization
RAVENSWOOD HEALTH CENTER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON G. FENNEMA D.C. (OWNER/PRESIDENT)
(773) 327-2225
Entity
Organization
Contact information
Practice address
4256 N. RAVENSWOOD AVE., SUITE NUMBER 101, CHICAGO, IL 60613
(773) 327-2225
(773) 327-7554
Mailing address
4256 N. RAVENSWOOD AVE,, SUITE NUMBER 101, CHICAGO, IL 60613
(773) 327-2225
(773) 327-7554
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038-008864
IL
225100000X
Physical Therapist
070009516
IL
Other
Enumeration date
10/22/2007
Last updated
12/30/2014
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