Organization · NPI-2

Bioblu, LLC

Chiropractor · Hickory Hills, IL

NPI number1346495512
StatusActive
Last updated in NPPESAug 28, 2012

Details

NPI
1346495512
Entity type
Organization (NPI-2)
Legal business name
Bioblu, LLC
Organization subpart
No
Enumeration date
Dec 1, 2008
Last updated
Aug 28, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
111N00000X Chiropractor038011278ILYes
111NN0400X Chiropractor, Neurology038011278IL
111NN1001X Chiropractor, Nutrition038011278IL
111NT0100X Chiropractor, Thermography038011278IL
111NN0400X Chiropractor, Neurology038011143IL
111NT0100X Chiropractor, Thermography038011143IL

Practice location

9229 S 78th Ave
Hickory Hills, IL 60457-2133

Phone 866-288-3822

Mailing address

9229 S 78th Ave
Hickory Hills, IL 60457-2133

Phone 866-288-3822

Authorized official

Ryan Daniel Novak
Advisory Physician
8662883822

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