| Chicago Craniofacial Pain & Rehabilitation | |
|
401 W Prospect Ave Mount Prospect IL 60056-3031 | |
| (847) 255-2528 | |
| Not Available |
| Full Name | Chicago Craniofacial Pain & Rehabilitation |
|---|---|
| Speciality | Clinic/Center |
| Location | 401 W Prospect Ave, Mount Prospect, Illinois |
| Authorized Official Name and Position | Katherine Smoron (DOCTOR/OWNER) |
| Authorized Official Contact | 8472552528 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chicago Craniofacial Pain & Rehabilitation 401 W Prospect Ave Mount Prospect IL 60056-3031 Ph: (847) 255-2528 | Chicago Craniofacial Pain & Rehabilitation 401 W Prospect Ave Mount Prospect IL 60056-3031 Ph: (847) 255-2528 |
| NPI Number | 1144927138 |
|---|---|
| Provider Enumeration Date | 02/10/2023 |
| Last Update Date | 02/10/2023 |
| Certification Date | 02/10/2023 |
| Medicare PECOS PAC ID | 5496120834 |
|---|---|
| Medicare Enrollment ID | O20230417001762 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144927138 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| Provider Name | Katherine Smoron |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1205542487 PECOS PAC ID: 5698140044 Enrollment ID: I20230417002208 |
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