Healthcare Provider Details

I. General information

NPI: 1720572175
Provider Name (Legal Business Name): PATRICK CAULFIELD DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2018
Last Update Date: 06/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24W500 MAPLE AVE STE 105
NAPERVILLE IL
60540
US

IV. Provider business mailing address

24W500 MAPLE AVE STE 105
NAPERVILLE IL
60540-6056
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038013229
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: