Organization
CHICAGO HEIGHTS PAIN CENTER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN M. ROSENTHAL D.C. (PRESIDENT)
(708) 756-3200
Entity
Organization
Contact information
Practice address
1406 PARK AVE, CHICAGO HEIGHTS, IL 60411-3529
(708) 756-3200
Mailing address
1406 PARK AVE, CHICAGO HEIGHTS, IL 60411-3529
(708) 756-3200
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
60008781
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
212184
MEDICARE PART B PROVIDER
IL
Enumeration date
09/19/2007
Last updated
09/19/2007
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