NPI 1104199983 · live from the CMS NPI Registry
Active Health Ltd
Chiropractor in Park Ridge, IL. National Provider Identifier 1104199983, active.
NPI record
| NPI | 1104199983 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Chiropractor 111N00000X |
| Practice location | 1550 N Northwest Hwy Ste 206, Park Ridge, IL 60068 |
| Practice phone | 847-739-3120 |
| Mailing address | Po Box 2308, Glen Ellyn, IL 60138 |
| Enumerated | February 9, 2012 |
| Last updated | January 8, 2024 |
| Authorized official | John Panopoulos, President |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Chiropractor primary | 111N00000X | 038.9079 (IL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.