Provider Demographics
NPI:1073676490
Name:LOCKE, ALDRIDGE (DC)
Entity Type:Individual
Prefix:MR
First Name:ALDRIDGE
Middle Name:
Last Name:LOCKE
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 1:2060 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-1780
Mailing Address - Country:US
Mailing Address - Phone:708-798-5625
Mailing Address - Fax:708-798-6025
Practice Address - Street 1:2060 RIDGE RD
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-1780
Practice Address - Country:US
Practice Address - Phone:708-798-5625
Practice Address - Fax:708-798-6025
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor