Provider Demographics
NPI:1902075195
Name:PLANET CHIROPRATIC PLAINFIELD PC
Entity Type:Organization
Organization Name:PLANET CHIROPRATIC PLAINFIELD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:MAJORS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:815-372-0170
Mailing Address - Street 1:432 NORTH WEBER RD
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446-4945
Mailing Address - Country:US
Mailing Address - Phone:815-372-0170
Mailing Address - Fax:
Practice Address - Street 1:432 N WEBER RD
Practice Address - Street 2:
Practice Address - City:ROMEOVILLE
Practice Address - State:IL
Practice Address - Zip Code:60446-4945
Practice Address - Country:US
Practice Address - Phone:815-372-0170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038008819111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9932285OtherBC/BS
IL557240Medicare PIN