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PETERSON CHIROPRACTIC CLINIC SC NPI 1477763183


NPI Information

NPI: 1477763183
Provider Name: PETERSON CHIROPRACTIC CLINIC SC
Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
3044 W PETERSON AVE
CHICAGO, IL
ZIP 60659
Phone: (773) 743-0228
Get Directions

PETERSON CHIROPRACTIC CLINIC SC is a chiropractor in Chicago, IL. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. PETERSON CHIROPRACTIC CLINIC SC NPI is 1477763183. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3044 W PETERSON AVE
CHICAGO, IL
ZIP 60659-729
Phone: (773) 743-0228
Fax: (773) 743-0425

The provider's authorized official is Han K Cho .
The authorized official title is President and has the following contact phone number (773) 743-0228.

The enumeration date for this NPI number is 5/23/2007 and was last updated on 5/30/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1111N00000XChiropractor038005934ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1K16412MEDICARE ID-TYPE UNSPECIFIEDILLINOISINDIVIDUAL PROVIDER #
2211416MEDICARE ID-TYPE UNSPECIFIEDILLINOISGROUP PROVIDER #
3T38857MEDICARE UPINILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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