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NPI Code Detail

MEDICARE: DR. DAVID J MENNER D.C.

MEDICARE: DR. DAVID J MENNER D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor038-006436IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14923238OTHERILBCBS PROVIDER #

General Provider Information

NPI Number : 1528164399
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID J MENNER D.C.
Provider Business Mailing Address
First Line : 110 S WYNSTONE PARK DR
Second Line : SUITE 105
City : NORTH BARRINGTON
State : IL
Zip : 60010-6979
Country : US
Telephone Number : 847-540-6060
Fax Number :
Provider Business Practice Location Address
First Line : 110 S WYNSTONE PARK DR
Second Line : SUITE 105
City : NORTH BARRINGTON
State : IL
Zip : 60010-6979
Country : US
Telephone Number : 847-540-6060
Fax Number : 847-277-8012
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2006
Last Update Date : 09/20/2012

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