Provider Demographics
NPI:1548629512
Name:NAPERVILLE CHIROPRACTIC AND ACUPUNCTURE, LLC
Entity type:Organization
Organization Name:NAPERVILLE CHIROPRACTIC AND ACUPUNCTURE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:MCSHEA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-939-1019
Mailing Address - Street 1:1878 WISTERIA DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60503-7319
Mailing Address - Country:US
Mailing Address - Phone:630-939-1019
Mailing Address - Fax:630-718-1697
Practice Address - Street 1:3027 ENGLISH ROW AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-5105
Practice Address - Country:US
Practice Address - Phone:630-718-1700
Practice Address - Fax:630-718-1697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-18
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012079305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization