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General NPI Number Information
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NPI Number | 1336688597
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Entity Type | Individual
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Provider Name | ASHLEY LEDERMAN D.C.
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Gender | Female
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Dates
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Enumeration Date | 02/20/2017
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Last Update Date | 08/17/2020
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Provider Practice Location Address
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Address Line | 440 W BOUGHTON RD #102
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City | BOLINGBROOK
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State | IL
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Zip | 60440-1892
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Country | US
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Telephone | 630-517-9340
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Fax |
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Provider Business Mailing Address
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Address Line | 1275 BUTTERFIELD RD STE 110
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City | WHEATON
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State | IL
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Zip | 60189-8849
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Country | US
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Telephone | 630-510-0080
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 038013066
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License Number State | IL
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