Pro-Active Care Physical Medicine Sc

LBN: Pro-Active Care Physical Medicine Sc
Pro-Active Care Physical Medicine Sc is an health care organization with primary practice located at 2609 W Lawrence Ave , Chicago IL 60625-6895. The organization recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as the primary health care specialty. Pro-Active Care Physical Medicine Sc can be contacted via phone (773) 279-9344, or through Bouvin, Rae via phone (773) 279-9344.

Contact Information

Primary practice address
2609 W Lawrence Ave Chicago IL 60625-6895
Phone: (773) 279-9344
Fax: (773) 279-9345
Website:
Map and Directions
Authorized official contact:
Name: Bouvin, Rae Doctor of Chiropractic (DC)
Phone: (773) 279-9344

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 038010690 Illinois

Profile Details

NPI number 1356600712
LBN Legal business name Pro-Active Care Physical Medicine Sc
DBA Doing business as
Authorized official Bouvin, Rae Doctor of Chiropractic (DC)
Entity Organization
Organization subpart 1 No
Enumeration date May 4th, 2012
Last updated Feb 9th, 2016 - about 10 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 1356600712 NPPES
Illinois Other IL7812 MEDICARE PTAN

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