Healthcare Provider Details

I. General information

NPI: 1972672020
Provider Name (Legal Business Name): TIMOTHY K DURNIN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18037 TORRENCE AVE
LANSING IL
60438-2154
US

IV. Provider business mailing address

1120 BARRINGTON CT
SCHERERVILLE IN
46375-1388
US

V. Phone/Fax

Practice location:
  • Phone: 708-895-3228
  • Fax: 708-895-1057
Mailing address:
  • Phone: 708-895-3228
  • Fax: 708-895-1057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: