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Organization
WAUKEGAN MEDICAL AND REHABILITATION
Active
Organization
WAUKEGAN MEDICAL AND REHABILITATION
Active
Other names
Waukegan Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IVAN BRACIC D.C. (PRESIDENT-OWNER)
(847) 625-0202
Entity
Organization
Contact information
Practice address
1720 GRAND AVE, WAUKEGAN, IL 60085-3502
(847) 625-0202
(847) 625-0101
Mailing address
1720 GRAND AVE, WAUKEGAN, IL 60085-3502
(847) 625-0202
(847) 625-0101
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
038007449
IL
225200000X
Physical Therapy Assistant
160-004131
IL
Other
Enumeration date
01/04/2007
Last updated
01/19/2016
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