=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487776035
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LEHOUX CHIROPRACTIC CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/04/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 926 LEE ST
-----------------------------------------------------
City | DES PLAINES
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60016-6570
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-299-0909
-----------------------------------------------------
Fax | 847-299-9401
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 926 LEE ST
-----------------------------------------------------
City | DES PLAINES
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60016-6570
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-299-0909
-----------------------------------------------------
Fax | 847-299-9401
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. DANIEL JOSEPH LEHOUX
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 847-299-0909
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 038-3980215
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------