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General NPI Number Information
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NPI Number | 1538438940
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Entity Type | Organization
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Legal Business Name | RAJ DHINGRA, D.C., LTD
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Dates
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Enumeration Date | 12/14/2011
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Last Update Date | 12/14/2011
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Provider Practice Location Address
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Address Line | 6905-A WEST CERMAK ROAD
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City | BERWYN
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State | IL
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Zip | 60402-2175
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Country | US
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Telephone | 630-664-2792
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Fax |
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Provider Business Mailing Address
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Address Line | 6905-A WEST CERMAK ROAD
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City | BERWYN
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State | IL
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Zip | 60402-2175
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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 | OWNER/CHIROPRACTOR
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Name | DR. TILAK R DHINGRA
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Credential | D.C.
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Telephone | 630-664-2792
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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 | 038011823
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License Number State | IL
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