Provider Demographics
NPI:1730357203
Name:PROGRESSIVE ATHLETICS, S.C.
Entity type:Organization
Organization Name:PROGRESSIVE ATHLETICS, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:CHERK-MUN
Authorized Official - Last Name:HUI
Authorized Official - Suffix:
Authorized Official - Credentials:DC, ATC/L
Authorized Official - Phone:847-833-9354
Mailing Address - Street 1:956 N NELTNOR BLVD
Mailing Address - Street 2:SUITE 308
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185-5982
Mailing Address - Country:US
Mailing Address - Phone:847-833-9354
Mailing Address - Fax:
Practice Address - Street 1:956 N NELTNOR BLVD
Practice Address - Street 2:SUITE 308
Practice Address - City:WEST CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60185-5982
Practice Address - Country:US
Practice Address - Phone:847-833-9354
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-18
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty