NPI 1154792802 · live from the CMS NPI Registry
Active Health & Restoration, LLC
Chiropractor, Rehabilitation in Carol Stream, IL. National Provider Identifier 1154792802, active.
NPI record
| NPI | 1154792802 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Chiropractor, Rehabilitation 111NR0400X |
| Practice location | 640 E Saint Charles Rd, Suite 107, Carol Stream, IL 60188 |
| Practice phone | 630-923-5049 |
| Enumerated | October 7, 2015 |
| Last updated | June 24, 2016 |
| Authorized official | Alexander Earl, President, Clinic Director |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Chiropractor, Rehabilitation primary | 111NR0400X | 038.012819 (IL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.