# GROTHMAN CLINIC OF CHIROPRACTIC, PC

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

## Provider details

- **NPI number:** 1710986179
- **Authorized official:** DR. M WARNER GROTHMAN DC (PRESIDENT/CHIROPRACTOR)
- **Authorized official phone:** (630) 844-1244

## Contact information

- **Practice address:** 845 N LAKE ST, AURORA, IL 60506-3177
- **Practice address phone:** (630) 844-1244
- **Mailing address:** 845 N LAKE ST, AURORA, IL 60506-3177
- **Mailing address phone:** (630) 844-1244

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | IL | Yes |

## Other

- **Enumeration date:** 07/19/2005
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4515209 | BCBS | IL |