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Organization
ACTIVE BODY CHIROPRACTIC LTD
Active
Organization
ACTIVE BODY CHIROPRACTIC LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DYLAN P DRYNAN DC (VICE PRESIDENT / COO)
(312) 922-9868
Entity
Organization
Contact information
Practice address
1600 S INDIANA AVE, SUITE 2, CHICAGO, IL 60616-4732
(312) 922-9868
(312) 922-9869
Mailing address
1600 S INDIANA AVE, SUITE 2, CHICAGO, IL 60616-4732
(312) 922-9868
(312) 922-9869
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
060-008054
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01632378
BLUE CROSS BLUE SHIELD ID
IL
Enumeration date
07/02/2006
Last updated
10/25/2012
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