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Organization
EVERGREEN HEALTH CLINIC, LTD
Active
Organization
EVERGREEN HEALTH CLINIC, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN R CARPENTER (PRESIDENT)
(815) 728-1074
Entity
Organization
Contact information
Practice address
5511 N RIDGEWAY RD, RINGWOOD, IL 60072-9633
(815) 728-1074
Mailing address
5511 N RIDGEWAY RD, RINGWOOD, IL 60072-9633
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5682029
BXBS
IL
Enumeration date
01/03/2008
Last updated
01/03/2008
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