Healthcare Provider Details

I. General information

NPI: 1962604249
Provider Name (Legal Business Name): WADE J SIEGEL D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 S DOBSON RD STE 100
CHANDLER AZ
85224-5676
US

IV. Provider business mailing address

20280 N 59TH AVE STE 115-617
GLENDALE AZ
85308-6850
US

V. Phone/Fax

Practice location:
  • Phone: 602-795-8700
  • Fax: 602-795-8701
Mailing address:
  • Phone: 602-795-8700
  • Fax: 602-795-8701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberB00782
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberB782
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: