Provider Demographics
NPI:1043693575
Name:EARL, ALEXANDER E (DC)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:E
Last Name:EARL
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 1:640 E SAINT CHARLES RD STE 107
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-2614
Mailing Address - Country:US
Mailing Address - Phone:630-765-0575
Mailing Address - Fax:630-344-0963
Practice Address - Street 1:640 E SAINT CHARLES RD STE 17
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-3083
Practice Address - Country:US
Practice Address - Phone:630-765-0575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-01
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.012819111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation