1750384509 NPI number — BORRE CHIROPRACTIC, LTD.

Table of content: (NPI 1750384509)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750384509 NPI number — BORRE CHIROPRACTIC, LTD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BORRE CHIROPRACTIC, LTD.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BORRE CHIROPRACTIC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750384509
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/01/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2S610 STATE ROUTE 59
Provider Second Line Business Mailing Address:
UNIT 9
Provider Business Mailing Address City Name:
WARRENVILLE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60555-1459
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-393-2828
Provider Business Mailing Address Fax Number:
630-393-0292

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2S610 STATE ROUTE 59
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WARRENVILLE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60555-1459
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-393-2828
Provider Business Practice Location Address Fax Number:
630-393-0292
Provider Enumeration Date:
05/24/2005

Additional Information

Authorized Official

Authorized Official Last Name:
BORRE
Authorized Official First Name:
AMANDA
Authorized Official Middle Name:
BETH
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
630-393-2828

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7282480 . This is a "DR BORRE ID-AETNA" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 02232251 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 6937 . This is a "UNITED HEALTH SERVICE" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 996513 . This is a "GALAXY" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 661636 . This is a "AMERICAN CHIROPRACTIC NET" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 661636 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 7466464 . This is a "CLINIC ID-AETNA" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 2122346216301 . This is a "BEECH STREET" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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