Provider Demographics
NPI:1043207673
Name:DINNING, CHRISTOPHER GENE (DC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:GENE
Last Name:DINNING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:CHRIS
Other - Middle Name:G
Other - Last Name:DINNING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:704 S EAST ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT CARROLL
Mailing Address - State:IL
Mailing Address - Zip Code:61053-1460
Mailing Address - Country:US
Mailing Address - Phone:815-244-7746
Mailing Address - Fax:815-244-2011
Practice Address - Street 1:704 S EAST ST
Practice Address - Street 2:
Practice Address - City:MOUNT CARROLL
Practice Address - State:IL
Practice Address - Zip Code:61053-1460
Practice Address - Country:US
Practice Address - Phone:815-244-7746
Practice Address - Fax:815-244-2011
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-29
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06771111N00000X
IL038-010157111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL215526Medicare PIN