Provider Demographics
NPI:1023650199
Name:EYLES CHIROPRACTIC, PC
Entity type:Organization
Organization Name:EYLES CHIROPRACTIC, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:EYLES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:224-333-0071
Mailing Address - Street 1:4614 W ALGONQUIN RD
Mailing Address - Street 2:
Mailing Address - City:LAKE IN THE HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60156-6722
Mailing Address - Country:US
Mailing Address - Phone:224-333-0711
Mailing Address - Fax:224-333-0579
Practice Address - Street 1:4614 W ALGONQUIN RD
Practice Address - Street 2:
Practice Address - City:LAKE IN THE HILLS
Practice Address - State:IL
Practice Address - Zip Code:60156-6722
Practice Address - Country:US
Practice Address - Phone:224-333-0711
Practice Address - Fax:224-333-0579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-10
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty