Healthcare Provider Details

I. General information

NPI: 1306482427
Provider Name (Legal Business Name): OSCAR ERKENSWICK DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/24/2019
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1714 W SUNNYSIDE AVE APT 2R
CHICAGO IL
60640-5358
US

IV. Provider business mailing address

1714 W SUNNYSIDE AVE APT 2R
CHICAGO IL
60640-5358
US

V. Phone/Fax

Practice location:
  • Phone: 408-218-6856
  • Fax:
Mailing address:
  • Phone: 408-218-6856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038.014021
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number34510
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: