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Organization
NORTH SHORE PRO-ACTIVE HEALTH LLC
Active
Organization
NORTH SHORE PRO-ACTIVE HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JORDAN L LEASURE DC (DOCTOR)
(847) 362-4476
Entity
Organization
Contact information
Practice address
112 W LAKE ST, LIBERTYVILLE, IL 60048-1812
(847) 362-4476
(847) 367-5339
Mailing address
112 W LAKE ST, LIBERTYVILLE, IL 60048-1812
(847) 362-4476
(847) 367-5339
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038-010764
IL
Other
Enumeration date
06/29/2009
Last updated
03/03/2015
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