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Organization
PAUL T. HACKETT D.C., P.C.
Active
Organization
PAUL T. HACKETT D.C., P.C.
Active
Other names
Lake View Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL T HACKETT D.C. (PRESIDENT)
(773) 296-2225
Entity
Organization
Contact information
Practice address
3835 N BROADWAY ST, CHICAGO, IL 60613-3217
(773) 296-2225
(773) 296-0731
Mailing address
3835 N BROADWAY ST, CHICAGO, IL 60613-3217
(773) 296-2225
(773) 296-0731
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01632440
BLUECROSS BLUESHIELD
IL
Enumeration date
06/01/2007
Last updated
08/22/2020
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