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General NPI Number Information
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NPI Number | 1497463855
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Entity Type | Individual
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Provider Name | JUSTIN CHRISTOPHER CAMPOS DC
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Gender | Male
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Dates
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Enumeration Date | 11/14/2022
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 28070 E STATE RD STE A
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City | ISLAND LAKE
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State | IL
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Zip | 60042-9552
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Country | US
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Telephone | 847-487-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 2501 CHATHAM RD # 4022
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City | SPRINGFIELD
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State | IL
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Zip | 62704-4188
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Country | US
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Telephone |
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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 | CHR.0008596
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2021003453
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038.013669
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License Number State | IL
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