# CHAMPION CHIROPRACTIC PC

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

## Provider details

- **NPI number:** 1407473663
- **Authorized official:** DR. MUSA AYYAD (PRESIDENT/CEO)
- **Authorized official phone:** (224) 520-3852

## Contact information

- **Practice address:** 148 S BLOOMINGDALE RD STE 107E, BLOOMINGDALE, IL 60108-1491
- **Practice address phone:** (224) 520-3852
- **Mailing address:** 186 SWALLOW AVE, BLOOMINGDALE, IL 60108-1369
- **Mailing address phone:** (224) 520-3852

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/02/2020
- **Last updated:** 07/02/2020