Provider Demographics
NPI:1053773820
Name:BANKS FAMILY CHIROPRACTIC INC.
Entity type:Organization
Organization Name:BANKS FAMILY CHIROPRACTIC INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-768-9330
Mailing Address - Street 1:880 LEE ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-6420
Mailing Address - Country:US
Mailing Address - Phone:847-768-9330
Mailing Address - Fax:847-768-9336
Practice Address - Street 1:880 LEE ST
Practice Address - Street 2:SUITE 207
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-6420
Practice Address - Country:US
Practice Address - Phone:847-768-9330
Practice Address - Fax:847-768-9336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012954111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty