Healthcare Provider Details
I. General information
NPI: 1992707970
Provider Name (Legal Business Name): DARRELL WEHREND D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/10/2005
Last Update Date: 02/04/2010
Certification Date:
Deactivation Date: 03/21/2006
Reactivation Date: 03/30/2006
III. Provider practice location address
777 OAKMONT LN SUITE 1000
WESTMONT IL
60559-5511
US
IV. Provider business mailing address
777 OAKMONT LN SUITE 1000
WESTMONT IL
60559-5511
US
V. Phone/Fax
- Phone: 630-323-2225
- Fax: 630-323-5230
- Phone: 630-323-2225
- Fax: 630-323-5230
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 038-008598 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: