Provider Demographics
NPI:1043578917
Name:CAMPTON CHIROPRACTIC, LTD
Entity Type:Organization
Organization Name:CAMPTON CHIROPRACTIC, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MALLORI
Authorized Official - Middle Name:
Authorized Official - Last Name:DOMBROCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-917-7406
Mailing Address - Street 1:40W131 CAMPTON CROSSINGS DR
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60175-6570
Mailing Address - Country:US
Mailing Address - Phone:630-917-7406
Mailing Address - Fax:
Practice Address - Street 1:40W131 CAMPTON CROSSINGS DR
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60175-6570
Practice Address - Country:US
Practice Address - Phone:630-917-7406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-30
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012123111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty