Provider Demographics
NPI:1548971377
Name:MIND AND BODY CHIROPRACTIC INC
Entity type:Organization
Organization Name:MIND AND BODY CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HOUSTON
Authorized Official - Middle Name:ORLANDO
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-301-9824
Mailing Address - Street 1:3251 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:DEKALB
Mailing Address - State:IL
Mailing Address - Zip Code:60115-7908
Mailing Address - Country:US
Mailing Address - Phone:815-517-1637
Mailing Address - Fax:
Practice Address - Street 1:3251 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:DEKALB
Practice Address - State:IL
Practice Address - Zip Code:60115-7908
Practice Address - Country:US
Practice Address - Phone:815-517-1637
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty