Provider Demographics
NPI:1730231945
Name:PREFERRED CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:PREFERRED CHIROPRACTIC CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EVANGELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SKOKOS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-543-0147
Mailing Address - Street 1:715 W LAKE ST
Mailing Address - Street 2:102
Mailing Address - City:ADDISON
Mailing Address - State:IL
Mailing Address - Zip Code:60101-2082
Mailing Address - Country:US
Mailing Address - Phone:630-543-0147
Mailing Address - Fax:630-543-0423
Practice Address - Street 1:715 W LAKE ST
Practice Address - Street 2:SUITE 104
Practice Address - City:ADDISON
Practice Address - State:IL
Practice Address - Zip Code:60101-2082
Practice Address - Country:US
Practice Address - Phone:630-543-0147
Practice Address - Fax:630-543-0423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty