OrganizationActive
Back to Life Chiropractic, Sc
NPI 1194983650 · Sports Physician Chiropractor · Glenview, IL
Provider details
- NPI number
- 1194983650
- Entity type
- Organization
- Primary specialty
- Sports Physician ChiropractorChiropractic Providers
- Organization subpart
- No
- Authorized official
- Thomas Godbout, President(847) 917-3097
- License
- 038010264 (IL)
Specialties & taxonomies
Chiropractic Providers
Practice location
1352 Patriot Blvd
Glenview, IL 60026-7777
Phone: (847) 917-3097
Approximate (ZIP-level) locationGet directions
Mailing address
454 N Ida Ln
Elmhurst, IL 60126-2210
Registry dates
- Enumerated
- 2008-05-30
- Last updated
- 2008-09-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.