1902223233 NPI number — ADVANCED CHIROPRACTIC HEALTH AND WELLNESS INSTITUTE, LTD.

Table of content: CATHERINE ELIZABETH LONG FNP (NPI 1932828779)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902223233 NPI number — ADVANCED CHIROPRACTIC HEALTH AND WELLNESS INSTITUTE, LTD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED CHIROPRACTIC HEALTH AND WELLNESS INSTITUTE, 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:
Provider Other Organization Name Type Code:
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:
1902223233
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/25/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2580 FOXFIELD RD
Provider Second Line Business Mailing Address:
SUITE 202
Provider Business Mailing Address City Name:
ST CHARLES
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60174-1403
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-549-7584
Provider Business Mailing Address Fax Number:
630-549-7586

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2580 FOXFIELD RD
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
SAINT CHARLES
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60174-1403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-549-7584
Provider Business Practice Location Address Fax Number:
630-549-7586
Provider Enumeration Date:
03/25/2014

Additional Information

Authorized Official

Authorized Official Last Name:
HURANI
Authorized Official First Name:
SHAREEN
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIROPRACTIC PHYSICIAN/PRESIDENT
Authorized Official Telephone Number:
630-549-7584

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  038012284 , 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)





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