# CHICAGO SPINE INSTITUTE PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285879098
- **Authorized official:** DR. LOREN DAVIS D.C. (PRESIDENT)
- **Authorized official phone:** (815) 838-7746

## Contact information

- **Practice address:** 16622 W 159TH ST STE 500, LOCKPORT, IL 60441-8015
- **Practice address phone:** (815) 838-7746
- **Mailing address:** 16622 W 159TH ST STE 500, LOCKPORT, IL 60441-8015
- **Mailing address phone:** (815) 838-7746

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111NR0400X | Rehabilitation Chiropractor | — | NULL | Yes |
| 111NR0400X | Rehabilitation Chiropractor | — | — | Yes |

## Other

- **Enumeration date:** 12/08/2008
- **Last updated:** 01/07/2009