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Organization
LOLITA A. WILBURN D.C.P.C.
Active
Organization
LOLITA A. WILBURN D.C.P.C.
Active
Other names
Back To Heatlh Chiropractic-Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOLITA A WILBURN D.C (DIRECTOR)
(708) 489-2225
Entity
Organization
Contact information
Practice address
12647 S JUSTINE ST, CALUMET PARK, IL 60827-6009
(708) 489-2225
(798) 489-2610
Mailing address
12647 S JUSTINE ST, CALUMET PARK, IL 60827-6009
(708) 489-2225
(798) 489-2610
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038007208
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01622136
BLUE CROSSBLUE SHIELD
IL
05
—
038007208
—
IL
Enumeration date
07/02/2007
Last updated
02/03/2009
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