Provider Demographics
NPI:1609188788
Name:COMPREHENSIVE FAMILY HEALTH CENTER, SC
Entity type:Organization
Organization Name:COMPREHENSIVE FAMILY HEALTH CENTER, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DC/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOMINIC
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:RANALLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-683-0077
Mailing Address - Street 1:PO BOX 200
Mailing Address - Street 2:
Mailing Address - City:HAMPSHIRE
Mailing Address - State:IL
Mailing Address - Zip Code:60140-0200
Mailing Address - Country:US
Mailing Address - Phone:847-683-0077
Mailing Address - Fax:847-683-1022
Practice Address - Street 1:3973 W ALGONQUIN RD
Practice Address - Street 2:
Practice Address - City:ALGONQUIN
Practice Address - State:IL
Practice Address - Zip Code:60102-9700
Practice Address - Country:US
Practice Address - Phone:847-658-7004
Practice Address - Fax:847-658-7066
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPREHENSIVE FAMILY HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-06
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty