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General NPI Number Information
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NPI Number | 1073793345
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Entity Type | Organization
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Legal Business Name | BRETON CHIROPRACTIC, LTD
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Dates
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Enumeration Date | 11/05/2007
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Last Update Date | 08/03/2024
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Provider Practice Location Address
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Address Line | 815 E RAND RD
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60004-4007
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Country | US
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Telephone | 847-368-1234
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Fax | 847-603-7478
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Provider Business Mailing Address
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Address Line | 815 E RAND RD
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60004-4007
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Country | US
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Telephone | 847-368-1234
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Fax | 847-603-7478
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Authorized Official
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Title or Position | PRESIDENT, CEO
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Name | DR. SHAWN M BRETON
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Credential | DC DABCI
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Telephone | 847-368-1234
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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 | 038.009584
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 111NI0900X
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Taxonomy Name | Internist Chiropractor
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License Number | 038008779
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License Number State | IL
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