Healthcare Provider Details

I. General information

NPI: 1780822189
Provider Name (Legal Business Name): MARK JAMES SACHSE D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2009
Last Update Date: 07/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5623 N CLARK ST
CHICAGO IL
60660-4108
US

IV. Provider business mailing address

2625 BUTTERFIELD RD STE 301N
OAK BROOK IL
60523-1234
US

V. Phone/Fax

Practice location:
  • Phone: 773-754-3850
  • Fax: 773-754-3853
Mailing address:
  • Phone: 630-320-6400
  • Fax: 630-754-8792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number30962
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038-011918
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: