Organization
BROADWAY CHIROPRACTIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY J REBARCAK D.C. (OWNER)
(773) 784-6682
Entity
Organization
Contact information
Practice address
5439 N BROADWAY ST, CHICAGO, IL 60640-1703
(773) 784-6682
(773) 784-5735
Mailing address
5439 N BROADWAY ST, CHICAGO, IL 60640-1703
(773) 784-6682
(773) 784-5735
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38010607
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003902560
NPI
CO
Enumeration date
03/24/2007
Last updated
08/22/2020
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