Healthcare Provider Details

I. General information

NPI: 1164461679
Provider Name (Legal Business Name): CARRIE L SKONY D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 08/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 W 500 MAPLE AVE SUITE 105
NAPERVILLE IL
60540
US

IV. Provider business mailing address

829 S CHESTNUT AVE
ARLINGTON HEIGHTS IL
60005-2505
US

V. Phone/Fax

Practice location:
  • Phone: 630-428-4300
  • Fax: 630-428-4305
Mailing address:
  • Phone: 630-290-5169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038-010591
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: