Organization
JUSTIN BOYCE P.C.
Active
Other names
diversey health center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN BENNETT BOYCE D.C. (PRESIDENT)
(773) 472-7484
Entity
Organization
Contact information
Practice address
757 W DIVERSEY PKWY, CHICAGO, IL 60614-6505
(773) 472-7484
(773) 472-6716
Mailing address
757 W DIVERSEY PKWY, CHICAGO, IL 60614-6505
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
038010051
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1616934
BCBS PROVIDER NUMBER
IL
Enumeration date
02/06/2007
Last updated
08/30/2010
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