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General NPI Number Information
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NPI Number | 1629400759
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Entity Type | Organization
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Legal Business Name | HINSDALE EXPERIENCE CHIROPRACTIC LLC
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Dates
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Enumeration Date | 07/31/2013
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Last Update Date | 07/31/2013
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Provider Practice Location Address
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Address Line | 3000 WOODCREEK DR SUITE 120
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-5401
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Country | US
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Telephone | 312-841-0096
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Fax |
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Provider Business Mailing Address
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Address Line | 3000 WOODCREEK DR SUITE 120
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-5401
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Country | US
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Telephone | 312-841-0096
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID DOUGLAS WARMAN
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Credential | D.C.
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Telephone | 312-841-0096
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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 | 038.011363
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License Number State | IL
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