Provider Demographics
NPI:1861279390
Name:REHAB CHIRO ELIUD M SIERRA JR SOLE MBR
Entity type:Organization
Organization Name:REHAB CHIRO ELIUD M SIERRA JR SOLE MBR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIUD
Authorized Official - Middle Name:MIGUEL
Authorized Official - Last Name:SIERRA
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:630-877-7389
Mailing Address - Street 1:345 SHAWNEE DR
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-1966
Mailing Address - Country:US
Mailing Address - Phone:630-877-7389
Mailing Address - Fax:
Practice Address - Street 1:148 S BLOOMINGDALE RD STE 107C
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-1491
Practice Address - Country:US
Practice Address - Phone:630-877-7389
Practice Address - Fax:630-982-1278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-08
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty