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General NPI Number Information
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NPI Number | 1003299546
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Entity Type | Organization
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Legal Business Name | DUZEY FAMILY CHIROPRACTIC
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Dates
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Enumeration Date | 07/01/2015
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Last Update Date | 07/01/2015
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Provider Practice Location Address
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Address Line | 1117 S MILWAUKEE AVE STE D7
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City | LIBERTYVILLE
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State | IL
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Zip | 60048-5257
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Country | US
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Telephone | 847-367-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 1117 S MILWAUKEE AVE STE D7
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City | LIBERTYVILLE
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State | IL
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Zip | 60048-5257
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Country | US
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Telephone | 847-367-4900
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. WALTER P DUZEY
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Credential | DC
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Telephone | 847-367-4900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 038-007183
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License Number State | IL
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