Provider Demographics
NPI:1255636932
Name:MACEK, ADAM NICHOLAS (DC)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:NICHOLAS
Last Name:MACEK
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 1:716 CLARENDON LN
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-3226
Mailing Address - Country:US
Mailing Address - Phone:630-302-0845
Mailing Address - Fax:
Practice Address - Street 1:2744 FORGUE DR
Practice Address - Street 2:C106
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-4001
Practice Address - Country:US
Practice Address - Phone:630-302-0845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-11
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.011868111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor