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General NPI Number Information
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NPI Number | 1184806036
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Entity Type | Organization
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Legal Business Name | BUCEK CHIROPRACTIC, S.C.
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Dates
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Enumeration Date | 12/03/2007
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Last Update Date | 11/24/2014
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Provider Practice Location Address
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Address Line | 2562 W FABYAN PKWY
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City | BATAVIA
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State | IL
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Zip | 60510-1572
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Country | US
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Telephone | 331-248-5777
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Fax | 630-239-5687
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Provider Business Mailing Address
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Address Line | 2562 W FABYAN PKWY
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City | BATAVIA
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State | IL
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Zip | 60510-1572
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Country | US
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Telephone | 331-248-5777
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Fax | 630-239-5687
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DANIEL BUCEK
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Credential | D.C.
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Telephone | 331-248-5777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038010868
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License Number State | IL
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