Healthcare Provider Details

I. General information

NPI: 1033835194
Provider Name (Legal Business Name): SHENG HUA DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2022
Last Update Date: 10/17/2023
Certification Date: 10/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3060 OGDEN AVE STE 110
LISLE IL
60532-1686
US

IV. Provider business mailing address

9S350 STEARMAN DR
NAPERVILLE IL
60564-9445
US

V. Phone/Fax

Practice location:
  • Phone: 630-357-7320
  • Fax:
Mailing address:
  • Phone: 630-965-5858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038.013876
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: