Healthcare Provider Details

I. General information

NPI: 1871587139
Provider Name (Legal Business Name): WILLIAM CURTIS HERWIG DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2005
Last Update Date: 12/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 NORTH BLOOMINGTON STREET
STREATOR IL
61364-2087
US

IV. Provider business mailing address

PO BOX 423
STREATOR IL
61364-0423
US

V. Phone/Fax

Practice location:
  • Phone: 815-672-6961
  • Fax: 815-672-6891
Mailing address:
  • Phone: 815-672-6961
  • Fax: 815-672-6891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038007374
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: