Provider Demographics
NPI:1871707943
Name:WELLNESS BOUND CHIROPRACTIC AND ACUPUNCTURE CENTER INC.
Entity type:Organization
Organization Name:WELLNESS BOUND CHIROPRACTIC AND ACUPUNCTURE CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YOUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:312-658-3300
Mailing Address - Street 1:111 N WABASH AVE STE 712
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-1913
Mailing Address - Country:US
Mailing Address - Phone:312-658-3300
Mailing Address - Fax:312-658-3908
Practice Address - Street 1:111 N WABASH AVE STE 712
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-1913
Practice Address - Country:US
Practice Address - Phone:312-658-3300
Practice Address - Fax:312-658-3908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038009908111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty