Provider Demographics
NPI:1013025824
Name:FOSZCZ, DARRIN R (DC)
Entity Type:Individual
Prefix:DR
First Name:DARRIN
Middle Name:R
Last Name:FOSZCZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2207 N US HIGHWAY 12
Mailing Address - Street 2:SUITE E
Mailing Address - City:SPRING GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60081-9706
Mailing Address - Country:US
Mailing Address - Phone:815-675-9355
Mailing Address - Fax:815-675-9323
Practice Address - Street 1:2207 N US HIGHWAY 12
Practice Address - Street 2:SUITE E
Practice Address - City:SPRING GROVE
Practice Address - State:IL
Practice Address - Zip Code:60081-9706
Practice Address - Country:US
Practice Address - Phone:815-675-9355
Practice Address - Fax:815-675-9323
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-008496111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0004932017OtherBCBS PROVIDER #
IL364478173OtherTAX ID #
IL364478173OtherTAX ID #