Organization
CHIRO ONE WELLNESS CENTER OF LANSING SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAM WANG D.C. (COO)
(630) 468-1824
Entity
Organization
Contact information
Practice address
2390 172ND ST, LANSING, IL 60438-6002
(708) 474-4890
(708) 474-4899
Mailing address
2625 BUTTERFIELD RD, SUITE 301N, OAK BROOK, IL 60523-1234
(630) 468-1824
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01635113
BLUE CROSS BLUE SHIELD
IL
Enumeration date
07/26/2006
Last updated
03/01/2018
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