Provider Demographics
NPI:1053510263
Name:REDINGER, DARRIN MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:DARRIN
Middle Name:MICHAEL
Last Name:REDINGER
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 1:275 N YORK RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-2766
Mailing Address - Country:US
Mailing Address - Phone:630-617-9790
Mailing Address - Fax:630-559-1023
Practice Address - Street 1:275 N YORK ST STE 301
Practice Address - Street 2:SUITE 301
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-2784
Practice Address - Country:US
Practice Address - Phone:630-617-9790
Practice Address - Fax:630-559-1023
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL38010445111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL038010445Medicaid
IL038010445Medicaid