Organization
LAKEFRONT CHIROPRACTIC CENTER P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WARREN W BRUHL (PRESIDENT)
(847) 835-4700
Entity
Organization
Contact information
Practice address
630 VERNON AVE, SUITE F, GLENCOE, IL 60022-1681
(847) 835-4700
Mailing address
630 VERNON AVE, SUITE F, GLENCOE, IL 60022-1681
(847) 835-4700
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01618865
BCBS
IL
Enumeration date
10/22/2007
Last updated
04/16/2008
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