Provider Demographics
NPI:1619221835
Name:OPTIMAL HEALING, INC.
Entity type:Organization
Organization Name:OPTIMAL HEALING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MINA
Authorized Official - Middle Name:H
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:312-448-8122
Mailing Address - Street 1:2202 N LINCOLN AVE
Mailing Address - Street 2:SUITE #1
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-7170
Mailing Address - Country:US
Mailing Address - Phone:312-448-8122
Mailing Address - Fax:773-248-2058
Practice Address - Street 1:2202 N LINCOLN AVE
Practice Address - Street 2:SUITE #1
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-7170
Practice Address - Country:US
Practice Address - Phone:312-448-8122
Practice Address - Fax:773-248-2058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-09
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012243111NR0400X, 111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty