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Organization
CHIROPRACTIC PLUS
Active
Organization
CHIROPRACTIC PLUS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK FREDRICK D.C. (OWNER/DOCTOR)
(847) 662-1600
Entity
Organization
Contact information
Practice address
3930 WASHINGTON ST, SUITE B, GURNEE, IL 60031-5702
(847) 662-1600
(847) 662-1612
Mailing address
3930 WASHINGTON ST, SUITE B, GURNEE, IL 60031-5702
(847) 662-1600
(847) 662-1612
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038005092
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0024940161
BCBS
IL
01
—
0040143639
BCBS
IL
01
—
4915298
BCBSIL
IL
Enumeration date
09/18/2007
Last updated
10/06/2010
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