Organization
PRO-HOLISTIC INSTITUTE S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAE M BOUVIN D.C. (PRESIDENT)
(773) 739-9017
Entity
Organization
Contact information
Practice address
2343 W MONTROSE AVE, UNIT A, CHICAGO, IL 60618-1866
(773) 739-9017
Mailing address
2343 W MONTROSE AVE, UNIT A, CHICAGO, IL 60618-1866
(773) 739-9017
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1750466991
EDGARDO VARGAS NPI
IL
01
—
1891727145
RAE BOUVIN NPI
IL
Enumeration date
03/18/2009
Last updated
03/18/2009
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