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General NPI Number Information
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NPI Number | 1811179070
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Entity Type | Organization
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Legal Business Name | DR KRISTINA L SARGENT, LTD
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Dates
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Enumeration Date | 11/29/2007
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Last Update Date | 11/04/2010
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Provider Practice Location Address
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Address Line | 416 E ROOSEVELT RD SUITE 107
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City | WHEATON
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State | IL
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Zip | 60187-5589
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Country | US
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Telephone | 630-682-5090
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Fax | 630-260-1230
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Provider Business Mailing Address
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Address Line | 416 E ROOSEVELT RD SUITE 107
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City | WHEATON
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State | IL
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Zip | 60187-5589
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Country | US
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Telephone | 630-682-5090
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Fax | 630-260-1230
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Authorized Official
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Title or Position | OWNER / COE
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Name | DR. KRISTINA L SARGENT
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Credential | D.C.
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Telephone | 630-682-5090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | 038007040
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 111NI0900X
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Taxonomy Name | Internist Chiropractor
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License Number | 038007040
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License Number State | IL
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