Healthcare Provider Details

I. General information

NPI: 1902747017
Provider Name (Legal Business Name): JACK ANDREW LAMBERT DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42W295 FOXFIELD DR
SAINT CHARLES IL
60175-7904
US

IV. Provider business mailing address

42W295 FOXFIELD DR
SAINT CHARLES IL
60175-7904
US

V. Phone/Fax

Practice location:
  • Phone: 630-940-9140
  • Fax:
Mailing address:
  • Phone: 630-940-9140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038.024436
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: