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Organization
SYCAMORE SERVICE CORPORATION
Active
Organization
SYCAMORE SERVICE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN M. COOP D.C. (CLINIC DIRECTOR)
(815) 899-6061
Entity
Organization
Contact information
Practice address
1680 MEDITERRANEAN DR, UNIT 101, SYCAMORE, IL 60178-3142
(815) 899-6061
Mailing address
1680 MEDITERRANEAN DR, UNIT 101, SYCAMORE, IL 60178-3142
(815) 899-6061
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114089109
PROVIDER NPI
IL
Enumeration date
06/06/2007
Last updated
08/08/2008
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