Healthcare Provider Details

I. General information

NPI: 1922034784
Provider Name (Legal Business Name): DEAN EARL BURCHENSON, D.C., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2446 LINCOLN HWY
OLYMPIA FIELDS IL
60461-1904
US

IV. Provider business mailing address

2446 WEST LINCOLN HIGHWAY
OLYMPIA FIELDS IL
60461
US

V. Phone/Fax

Practice location:
  • Phone: 708-481-7722
  • Fax: 708-481-7531
Mailing address:
  • Phone: 708-481-7722
  • Fax: 708-481-7531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. DEAN EARL BURCHENSON
Title or Position: PRESIDENT
Credential: D.C.
Phone: 708-691-5823