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General NPI Number Information
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NPI Number | 1598449027
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Entity Type | Individual
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Provider Name | ASHLEY SPELLER DC
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Gender | Female
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Dates
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Enumeration Date | 06/14/2023
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Last Update Date | 06/14/2023
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Provider Practice Location Address
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Address Line | 114 W CALENDAR AVE
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City | LA GRANGE
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State | IL
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Zip | 60525-2601
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Country | US
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Telephone | 708-308-4585
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Fax |
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Provider Business Mailing Address
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Address Line | 4740 S WOODLAWN AVE APT G
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City | CHICAGO
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State | IL
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Zip | 60615-1941
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Country | US
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Telephone | 313-729-5302
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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 | 038.013975
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License Number State | IL
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