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General NPI Number Information
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NPI Number | 1790938744
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Entity Type | Organization
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Legal Business Name | LIFE SPRING CHIROPRACTIC, P.C.
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Dates
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Enumeration Date | 11/03/2008
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Last Update Date | 10/04/2015
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Provider Practice Location Address
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Address Line | 381 N YORK ST STE 23
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City | ELMHURST
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State | IL
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Zip | 60126-2364
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Country | US
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Telephone | 630-478-9311
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Fax | 331-642-1219
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Provider Business Mailing Address
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Address Line | 1420 COLONY CT
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City | LOMBARD
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State | IL
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Zip | 60148-4416
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Country | US
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Telephone | 630-776-6379
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Fax | 331-642-1219
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAWN REGINA GASKEY
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Credential | DC
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Telephone | 630-776-6379
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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 | 038-008719
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License Number State | IL
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