Revive Chiropractic

LBN: Revive Chiropractic
Revive Chiropractic is an health care organization with primary practice located at 6615 W Irving Park Rd Ste. #301, Chicago IL 60634-2410. The organization recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as the primary health care specialty. Revive Chiropractic can be contacted via phone (772) 282-4300, or through Gozdalski, Witold T via phone (773) 282-4300.

Contact Information

Primary practice address
6615 W Irving Park Rd Ste. #301 Chicago IL 60634-2410
Phone: (772) 282-4300
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Gozdalski, Witold T
Phone: (773) 282-4300

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 038-009590 Indiana

Profile Details

NPI number 1629134804
LBN Legal business name Revive Chiropractic
DBA Doing business as
Authorized official Gozdalski, Witold T
Entity Organization
Organization subpart 1 No
Enumeration date Dec 29th, 2006
Last updated Aug 1st, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629134804 NPPES
Illinois Other 1633769 BCBS OF IL

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