Organization
NECK TO BACK LAKE COUNTY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID SERAFINI M.D. (MEDICAL DIRECTOR)
(847) 283-0950
Entity
Organization
Contact information
Practice address
71 WAUKEGAN RD, SUITE 100, LAKE BLUFF, IL 60044-3009
(847) 283-0950
(847) 283-0951
Mailing address
7177 CRIMSON RIDGE DR, SUITE 14, ROCKFORD, IL 61107-6208
(815) 227-9900
(815) 227-9805
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038010204
IL
207Q00000X
Family Medicine Physician
036104819
IL
261QE0002X
Emergency Care Clinic/Center
Primary
036-104819
IL
Other
Enumeration date
04/13/2007
Last updated
05/01/2008
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