Healthcare Provider Details

I. General information

NPI: 1336005560
Provider Name (Legal Business Name): CHASE HALONEN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/31/2025
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 SHADYWOOD RD STE 508
EXCELSIOR MN
55331-6201
US

IV. Provider business mailing address

97 GRANITE LN APT 427
DELANO MN
55328-2205
US

V. Phone/Fax

Practice location:
  • Phone: 612-219-3288
  • Fax:
Mailing address:
  • Phone: 612-219-3288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7384
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: