Organization
ITASCA HEALTH & CHIROPRACTIC LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOEL HANSON DC (DIRECTOR)
(630) 250-9200
Entity
Organization
Contact information
Practice address
1131 N PROSPECT AVE, ITASCA, IL 60143-1442
(630) 250-9200
Mailing address
1131 N PROSPECT AVE, ITASCA, IL 60143-1442
(630) 250-9200
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038-008856
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02227528
BLUE CROSS BLUE SHIELD
IL
Enumeration date
01/21/2007
Last updated
07/30/2020
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