Healthcare Provider Details
I. General information
NPI: 1063634202
Provider Name (Legal Business Name): SUPERCZYNSKI FAMILY CHIROPRACTIC, LTD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/03/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
600 S WASHINGTON ST SUITE200
NAPERVILLE IL
60540-6666
US
IV. Provider business mailing address
600 S WASHINGTON ST SUITE200
NAPERVILLE IL
60540-6666
US
V. Phone/Fax
- Phone: 630-355-4450
- Fax: 630-355-4950
- Phone: 630-355-4450
- Fax: 630-355-4950
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QH0100X |
| Taxonomy | Health Service Clinic/Center |
| License Number | |
| License Number State | IL |
VIII. Authorized Official
Name: DR.
STEVEN
EDWARD
SUPERCZYNSKI
Title or Position: OWNER
Credential: DC,FICPA,DACCP
Phone: 630-355-4450