Organization
SPINE AND JOINT REHABILITATION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARWIN MINNIS D.C. (PRESIDENT)
(708) 345-6630
Entity
Organization
Contact information
Practice address
1415 S 5TH AVE, MAYWOOD, IL 60153-2128
(708) 345-6630
(708) 345-9950
Mailing address
1415 S 5TH AVE, MAYWOOD, IL 60153-2128
(708) 345-6630
(708) 345-9950
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001621245
BLUE CROSS BLUE SHIELD
IL
Enumeration date
12/19/2006
Last updated
12/31/2007
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