Organization
LAKESIDE SPINE AND WELLNESS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW M KIPER DC (OWNER)
(773) 828-9506
Entity
Organization
Contact information
Practice address
1828 W WILSON AVE, CHICAGO, IL 60640-5204
(773) 828-9506
(773) 439-5168
Mailing address
PO BOX 180021, CHICAGO, IL 60618-0509
(773) 767-3822
(773) 337-9106
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038013006
IL
Other
Enumeration date
08/26/2016
Last updated
07/21/2022
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