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General NPI Number Information
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NPI Number | 1386974160
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Entity Type | Organization
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Legal Business Name | L. HUMBERSTONE D.C., SC
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Dates
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Enumeration Date | 12/30/2009
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Last Update Date | 05/18/2010
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Provider Practice Location Address
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Address Line | 303 E ARMY TRAIL ROAD 101
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2155
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Country | US
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Telephone | 630-529-2225
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Fax | 630-529-0137
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Provider Business Mailing Address
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Address Line | 303 E ARMY TRAIL ROAD 101
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2155
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Country | US
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Telephone | 630-529-2225
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Fax | 630-529-0137
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LAWRENCE HUMBERSTONE
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Credential |
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Telephone | 630-529-2225
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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 | 038005562
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License Number State | IL
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