Healthcare Provider Details

I. General information

NPI: 1104173731
Provider Name (Legal Business Name): SEAN COONEY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2012
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 NORTH LASALLE DRIVE UNIT 2W
CHICAGO IL
60610
US

IV. Provider business mailing address

5016 N SHERIDAN RD UNIT 1S
CHICAGO IL
60640-3168
US

V. Phone/Fax

Practice location:
  • Phone: 312-900-2640
  • Fax: 312-588-7242
Mailing address:
  • Phone: 630-209-5259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038011989
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: