MARQUE MEDICOS ARCHER, LLC (NPI# 1366681025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366681025 |
| Entity Type | Organization |
| Organization Name | MARQUE MEDICOS ARCHER, LLC |
| Practice Address |
4195 S Archer Ave Chicago IL 60632-1849 |
| Mailing Address |
4176 W Montrose Ave Chicago IL 60641-2161 |
| Practice Telephone | 7732833131 |
| Practice Fax Number | 7732833610 |
| Mailing Telephone | 7732833131 |
| Mailing Fax Number | 7732833610 |
| Enumeration Date | 2009-02-19 |
| Last Update Date | 2009-02-19 |
| Authorized Official Name | DR. DERRICK D. WALLERY (MANAGER) |
| Authorized Official Telephone | 7732833131 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 038008088 | IL | Chiropractic Providers |
| Street Address |
4195 S ARCHER AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60632-1849 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740650696 | Lopez Family Chiropractic S.c. | Physical Therapist | 4195 S Archer Ave, Chicago, IL 60632-1849 | 2015-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104474790 | Amanda Rose Dirnberger | Nurse Practitioner | 3229-43 W. 47th Pl., Chicago, IL 60632 | 2019-08-28 |
| 1982121042 | Brown Archer Dental PC | Dentist | 4893 S Archer Ave, Chicago, IL 60632 | 2017-08-29 |
| 1538577085 | Metrosmiles - Archer Heights Dental | Dentist | 5141 S Cicero Ave, Chicago, IL 60632 | 2014-07-29 |
| 1174955173 | Thresholds | Community/Behavioral Health | 718-24 West 47th St, Chicago, IL 60632 | 2013-08-01 |
| 1659612570 | Sapex Home Healthcare, Inc. | In Home Supportive Care | 4107 West 47th Street, Chicago, IL 60632 | 2013-03-04 |
| 1912275462 | Dawn Marie Mackessy | Pharmacist | 5435 S. Kedzie Ave, Chicago, IL 60632 | 2011-12-12 |
| 1033494752 | Molly Elizabeth Mcdermott | Pharmacist | District 222-walgreens, Chicago, IL 60632 | 2011-10-13 |
| 1780908434 | Chicago Electrical Trauma Research Institute | Specialist/Technologist, Other | 4047 W. 40th Street, Chicago, IL 60632 | 2010-03-24 |
| 1265765218 | 4365 Archer Mri, LLC | Clinic/Center | 4365 South Archer Avenue, Chicago, IL 60632 | 2009-09-09 |
| 1295968121 | Smile Lee Faces | Dentist | 4197 S Archer Ave, Chicago, IL 60632 | 2009-08-26 |
| Find all providers in zip 60632 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881208080 | Christian James Koch | Chiropractor | 5100 N Ravenswood Ave Ste 107, Chicago, IL 60640-1710 | 2020-09-04 |
| 1164035879 | Scott Spine and Health LLC | Chiropractor | 2560 W. Armitage Ave, Unit C2, Chicago, IL 60647 | 2020-08-24 |
| 1104448547 | Katie Niebur | Chiropractor | 6909 W Medill Ave, Chicago, IL 60707-2910 | 2020-05-07 |
| 1063031003 | Bazan's Health Center Inc | Chiropractor | 4012 W 63rd St, Chicago, IL 60629-4606 | 2020-04-09 |
| 1346875861 | Christopher A Haslett Dc P.c | Chiropractor | 400 N Wells St Ste 300, Chicago, IL 60654-2761 | 2020-03-04 |
| 1245870138 | Be Well Chiropractic Clinics LLC | Chiropractor | 3648 W Montrose Ave Apt 2e, Chicago, IL 60618-1979 | 2020-01-08 |
| 1982242186 | Michael Tal Risher | Chiropractor | 2378 N Elston Ct, Chicago, IL 60614-2929 | 2019-12-18 |
| 1821632423 | Rachel Nicole Leibovitz | Chiropractor | 624 W Belmont Ave, Chicago, IL 60657-4511 | 2019-11-06 |
| 1053954180 | Aaron Alexander Bryant | Chiropractor | 125 N Halsted St Ste 202, Chicago, IL 60661-2160 | 2019-10-22 |
| 1073156238 | Omar A. Bleibel | Chiropractor | 4801 W Peterson Ave Ste 505, Chicago, IL 60646-5795 | 2019-10-21 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.