National Provider Identifier Database

SITSADAPHONE PHETCHAMPHONE, DC – NPI #1780739284
Chiropractor

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.


Contact Information

SITSADAPHONE PHETCHAMPHONE, DC
1157 W 18TH ST
CHICAGO, IL60608
Phone: 312-344-1632
Fax:
Website:
Specialty Taxonomy Code
* Chiropractor 111N00000X

* Indicates primary specialty

NPI Profile & details for SITSADAPHONE PHETCHAMPHONE

NPI Number 1780739284
Credentials DC (Doctor of Chiropractic)
Entity Individual
Enumeration date 01/24/2007
Last updated 02/08/2019 - About 7 years ago
Sole proprietor1 No
Identifiers
  • IL License #: 038-010281
  • IL License #: 038010281
  • IL Other: 2232625 BLUE CROSS BLUE SHIELD
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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