Organization
CHIROSPAAAH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHERIEKA ADDISON (OFFICE MANAGER)
(708) 891-2006
Entity
Organization
Contact information
Practice address
944 EAST 162ND ST., SOUTH HOLLAND, IL 60473
(708) 891-2006
(708) 891-2076
Mailing address
944 EAST 162ND ST., SOUTH HOLLAND, IL 60473
(708) 891-2006
(708) 891-2076
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1632889
BLUECROSSBLUE SHIELD
IL
01
—
1635092
BLUE CROSS BLUE SHIELD
IL
05
—
364476461
—
IL
Enumeration date
08/13/2007
Last updated
07/21/2022
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