Basic Information
| Provider Information | |||||||||
| NPI: | 1487855482 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ARMITAGE CHIROPRACTIC & WELLNESS CENTER LTD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2052 N CLEVELAND AVE | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606144505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7732812225 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2052 N CLEVELAND AVE | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606144505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7732812225 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2007 | ||||||||
| LastUpdateDate: | 11/27/2020 | ||||||||
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| AuthorizedOfficialLastName: | GOELZ | ||||||||
| AuthorizedOfficialFirstName: | BRIAN | ||||||||
| AuthorizedOfficialMiddleName: | D | ||||||||
| AuthorizedOfficialTitleorPosition: | PRES. | ||||||||
| AuthorizedOfficialTelephone: | 7732812225 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | D.C. | ||||||||
| NPICertificationDate: | 11/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | X008725-1 | NY | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Chiropractic Providers | Chiropractor | 111N00000X | 038-007867 | IL | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Chiropractic Providers | Chiropractor |
No ID Information.