Organization
BRIDGEPORT PAIN CONTROL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL LEVY D.C. (DIRECTOR)
(773) 254-8977
Entity
Organization
Contact information
Practice address
735 W 35TH ST, CHICAGO, IL 60616-4481
(773) 254-8977
(773) 254-8944
Mailing address
735 W 35TH ST, CHICAGO, IL 60616-4481
(773) 254-8977
(773) 254-8944
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1616680
BLUE CROSS
IL
Enumeration date
01/03/2007
Last updated
08/22/2020
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