Provider Demographics
NPI:1871799445
Name:BACK 2 HEALTH INC.
Entity type:Organization
Organization Name:BACK 2 HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAIGH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-782-9280
Mailing Address - Street 1:3900 WASHINGTON ST STE I
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-5715
Mailing Address - Country:US
Mailing Address - Phone:847-782-9280
Mailing Address - Fax:847-782-9285
Practice Address - Street 1:3900 WASHINGTON ST STE I
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-5715
Practice Address - Country:US
Practice Address - Phone:847-782-9280
Practice Address - Fax:847-782-9285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL03801029111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK17796Medicare ID - Type UnspecifiedDOCTOR MEMBER #
IL211723Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER