Provider Demographics
NPI:1730227208
Name:FAMILY CHIROPRACTIC LTD.
Entity type:Organization
Organization Name:FAMILY CHIROPRACTIC LTD.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:MOREY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:708-301-6411
Mailing Address - Street 1:12448 W 143RD ST
Mailing Address - Street 2:
Mailing Address - City:HOMER GLEN
Mailing Address - State:IL
Mailing Address - Zip Code:60491-6894
Mailing Address - Country:US
Mailing Address - Phone:708-301-6411
Mailing Address - Fax:708-301-3387
Practice Address - Street 1:12448 W 143RD ST
Practice Address - Street 2:
Practice Address - City:HOMER GLEN
Practice Address - State:IL
Practice Address - Zip Code:60491-6894
Practice Address - Country:US
Practice Address - Phone:708-301-6411
Practice Address - Fax:708-301-3387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL776070Medicare ID - Type Unspecified
ILT38918Medicare UPIN