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General NPI Number Information
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NPI Number | 1861684474
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Entity Type | Organization
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Legal Business Name | SYMMETRY CHIROPRACTIC & WELLNESS, LTD
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Dates
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Enumeration Date | 08/16/2007
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Last Update Date | 08/16/2007
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Provider Practice Location Address
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Address Line | 24115 103RD ST SUITE A
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City | NAPERVILLE
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State | IL
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Zip | 60564-8012
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Country | US
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Telephone | 630-983-1805
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Fax | 630-983-1845
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Provider Business Mailing Address
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Address Line | 24115 103RD ST SUITE A
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City | NAPERVILLE
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State | IL
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Zip | 60564-8012
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Country | US
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Telephone | 630-983-1805
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Fax | 630-983-1845
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TIMOTHY JAMES ERICKSON
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Credential | D.C.
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Telephone | 630-983-1805
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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 | 038-010212
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License Number State | IL
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