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Organization
NECK TO BACK LAKE COUNTY LLC
Active
Organization
NECK TO BACK LAKE COUNTY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID SERAFINI M.D. (MEDICAL DIRECTOR)
(847) 283-0950
Entity
Organization
Contact information
Practice address
71 WAUKEGAN RD, SUITE 100, LAKE BLUFF, IL 60044-3009
(847) 283-0950
(847) 283-0951
Mailing address
7177 CRIMSON RIDGE DR, SUITE 14, ROCKFORD, IL 61107-6208
(815) 227-9900
(815) 227-9805
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038010204
IL
207Q00000X
Family Medicine Physician
036104819
IL
261QE0002X
Emergency Care Clinic/Center
Primary
036-104819
IL
Other
Enumeration date
04/13/2007
Last updated
05/01/2008
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