NPI 1154780617 · live from the CMS NPI Registry
Active Life & Sports Chiropractic LLC
Chiropractor in Lombard, IL. National Provider Identifier 1154780617, active.
NPI record
| NPI | 1154780617 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Chiropractor 111N00000X |
| Practice location | 929 S Main St, Unit 107a, Lombard, IL 60148 |
| Practice phone | 630-519-6284 |
| Enumerated | February 12, 2016 |
| Last updated | February 12, 2016 |
| Authorized official | Frank Frydrych, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Chiropractor primary | 111N00000X | 038011082 (IL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.