Provider Demographics
NPI:1730325317
Name:HINES, ANDRE CHRISTOPHER (DC)
Entity type:Individual
Prefix:DR
First Name:ANDRE
Middle Name:CHRISTOPHER
Last Name:HINES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5988
Mailing Address - Street 2:DEPT. 20-5001
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60197-5988
Mailing Address - Country:US
Mailing Address - Phone:630-468-1831
Mailing Address - Fax:630-468-1834
Practice Address - Street 1:1522 N HALSTED ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60642-2528
Practice Address - Country:US
Practice Address - Phone:312-379-5000
Practice Address - Fax:312-379-5060
Is Sole Proprietor?:No
Enumeration Date:2009-01-02
Last Update Date:2009-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor