Healthcare Provider Details

I. General information

NPI: 1720123797
Provider Name (Legal Business Name): CHICAGO NEUROSCIENCE INSTITUTE, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 02/03/2023
Certification Date: 01/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1795 GRANDSTAND PL
ELGIN IL
60123-4980
US

IV. Provider business mailing address

1795 GRANDSTAND PL
ELGIN IL
60123-4980
US

V. Phone/Fax

Practice location:
  • Phone: 847-888-1811
  • Fax: 847-888-1868
Mailing address:
  • Phone: 847-888-1811
  • Fax: 847-888-1868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038-004673
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID H. DURRANT
Title or Position: DIRECTOR
Credential: DC, PHD
Phone: 847-888-1811