Provider Demographics
NPI:1689892929
Name:CELAR CHIROPRACTIC LTD
Entity type:Organization
Organization Name:CELAR CHIROPRACTIC LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CELAR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:708-449-5900
Mailing Address - Street 1:4413 ROOSEVELT RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HILLSIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60162-2074
Mailing Address - Country:US
Mailing Address - Phone:708-449-5900
Mailing Address - Fax:708-449-5901
Practice Address - Street 1:4413 ROOSEVELT RD
Practice Address - Street 2:SUITE 100
Practice Address - City:HILLSIDE
Practice Address - State:IL
Practice Address - Zip Code:60162-2074
Practice Address - Country:US
Practice Address - Phone:708-449-5900
Practice Address - Fax:708-449-5901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01634941OtherBCBS
ILU85409Medicare UPIN
IL210075Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER PIN
IL01634941OtherBCBS
ILV01770Medicare UPIN