Lakefront Chiropractic
Organization Active NPI Chiropractor · Glencoe, IL
NPI 1972990737 · NPPES record last updated Apr 20, 2015
Key facts
- NPI
- 1972990737
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 227.002662 (IL)
- Legal business name
- LAKEFRONT CHIROPRACTIC
- Practice address
- 630 Vernon Ave
F
Glencoe, IL 60022-1681 - Phone
- (847) 835-4700
- NPI assigned
- Apr 20, 2015
- Organization subpart
- No
Authorized official
- Name
- Dr. Joseph Ethen, D.C.
- Title
- Owner/Doctor
- Phone
- (847) 835-4700
Corporate family (same tax ID) 2
Practitioners 1
-
Joseph John Ethen, D.C.
National Provider Directory
- Tax ID family
- Ethen Chiropractic and Wellness
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 227.002662 | IL | Yes |
Addresses
Primary practice location
630 Vernon Ave
F
Glencoe, IL 60022-1681
Mailing address
630 Vernon Ave
F
Glencoe, IL 60022-1681
Phone (847) 835-4700
Other providers in Glencoe, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.