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Organization
EDWARDS CHIROPRACTIC CLINIC
Active
Organization
EDWARDS CHIROPRACTIC CLINIC
Active
Other names
HealthSource of Richton Park
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARTH L. EDWARDS M.D., D.C. (PRESIDENT)
(708) 748-5600
Entity
Organization
Contact information
Practice address
22111 GOVERNORS HWY, RICHTON PARK, IL 60471-1249
(708) 748-5600
(708) 748-5635
Mailing address
22111 GOVERNORS HWY, RICHTON PARK, IL 60471-1249
(708) 748-5600
(708) 748-5635
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038005184
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F100233998
MEDICARE ID
IL
Enumeration date
10/14/2015
Last updated
10/14/2015
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