Provider Demographics
NPI:1871895011
Name:GLOBAL CHIROPRACTIC CARE LTD
Entity type:Organization
Organization Name:GLOBAL CHIROPRACTIC CARE LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MEHRAN
Authorized Official - Middle Name:RAZI
Authorized Official - Last Name:SOROURI
Authorized Official - Suffix:
Authorized Official - Credentials:DC, CSCS, CCSP
Authorized Official - Phone:773-525-8100
Mailing Address - Street 1:2051 W BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-6467
Mailing Address - Country:US
Mailing Address - Phone:773-525-8100
Mailing Address - Fax:773-525-8130
Practice Address - Street 1:2051 W BELMONT AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-6467
Practice Address - Country:US
Practice Address - Phone:773-525-8100
Practice Address - Fax:773-525-8130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-19
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038009498111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILU93425Medicare UPIN