Organization
CHICAGO HEIGHTS PAIN CENTER, P.C.
Active
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
Update your record
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