Organization
GLADSTONE CHIROPRACTIC GROUP LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIZABETH STIPISIC DC (OWNER)
(773) 774-1041
Entity
Organization
Contact information
Practice address
5316 B N MILWAUKEE AVENUE, CHICAGO, IL 60630-1266
(773) 774-1041
(773) 774-8541
Mailing address
5316 B N MILWAUKEE AVENUE, CHICAGO, IL 60630-1266
(773) 774-1041
(773) 774-8541
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038008327
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1630133
BCBS
IL
Enumeration date
04/11/2007
Last updated
06/24/2008
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