Verify Insurance

Complete the form below to send your insurance information to our office.

We will call and verify your insurance benefits prior to your arrival in our office!

Information About The Patient

Patient Name*

Patient Date Of Birth*

Information About The Policyholder

Policy Holder's Name*

Policy Holder's Date Of Birth*

Patient Relationship To Policyholder*

If Other, please specify:

Information About Your Insurance

Insurance Company*

Membership ID Number*

Group Number*

Phone Number For Providers, Or Customer Service Number*

Information To Contact You

Best Contact Phone Number*

Best Contact E-mail*

Any Additional Information?

Why Choose Us?

We are certified providers of corrective chiropractic treatments which combine chiropractic, exercise and focused stretching to produce lasting and measurable changes.

New Patient Special

Contact us today for a no-obligation, no-cost initial consultation.

Serving Our Community

We proudly serve the Northshore, Northbrook, Highland Park, Deerfield, and Glencoe communities.

Align Wellness Center
5 Star Rating, 48 Google Reviews
900 Skokie Blvd Suite 113
Northbrook, IL 60062