Provider Demographics
NPI:1174692255
Name:KARWOWSKI, BRIAN CHARLES (DC)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:CHARLES
Last Name:KARWOWSKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 W PARK AVE
Mailing Address - Street 2:STE. C
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-6201
Mailing Address - Country:US
Mailing Address - Phone:630-359-5483
Mailing Address - Fax:630-359-5624
Practice Address - Street 1:110 W PARK AVE
Practice Address - Street 2:STE. C
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-6201
Practice Address - Country:US
Practice Address - Phone:630-359-5483
Practice Address - Fax:630-359-5624
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2012-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010183111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK16560OtherMEMBER NUMBER
IL211452OtherMEDICARE PIN NUMBER
ILV04670Medicare UPIN