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Organization
BACK IN ACTION WELLNESS CENTER
Active
Organization
BACK IN ACTION WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VARSOVIA SANTOLIVA DC (OWNER)
(708) 385-9001
Entity
Organization
Contact information
Practice address
12757 WESTERN AVE, BLUE ISLAND, IL 60406-2155
(708) 385-9001
(708) 385-2114
Mailing address
PO BOX 554, BLUE ISLAND, IL 60406-0554
(708) 385-9001
(708) 385-2114
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02227830
BC/BS PROVIDER #
IL
01
—
U88474
DOCTOR UPIN #
IL
Enumeration date
08/01/2006
Last updated
01/29/2008
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