Organization
HEALTHSOURCE OF DEER PARK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. J. GRANT REFFELL D.C. (OWNER)
(847) 726-0044
Entity
Organization
Contact information
Practice address
20876 N RAND RD, DEER PARK, IL 60010-3707
(847) 726-0044
Mailing address
20876 N RAND RD, DEER PARK, IL 60010-3707
(847) 726-0044
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038007087
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
490-50-20
BLUECROSS BLUESHIELD
IL
Enumeration date
11/16/2007
Last updated
11/09/2014
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