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General NPI Number Information
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NPI Number | 1811306285
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Entity Type | Organization
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Legal Business Name | DEVON ACOU DC, LLC
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Dates
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Enumeration Date | 08/10/2014
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Last Update Date | 09/07/2022
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Provider Practice Location Address
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Address Line | 512 W BURLINGTON AVE STE 103
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City | LA GRANGE
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State | IL
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Zip | 60525-2234
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Country | US
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Telephone | 630-332-0166
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Fax | 630-332-5133
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Provider Business Mailing Address
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Address Line | 512 W BURLINGTON AVE STE 103
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City | LA GRANGE
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State | IL
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Zip | 60525-2234
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Country | US
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Telephone | 630-332-1066
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Fax | 630-332-5133
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DR. DEVON MARIE JAMES
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Credential | D.C.
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Telephone | 630-332-0166
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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 | 038012109
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License Number State | IL
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